Diffuse keratoconjunctival proliferation: a novel clinical manifestation.
OBJECTIVE
To report a previously unrecognized benign bilateral widespread conjunctival and corneal proliferative condition with a potential to affect vision.


METHODS
A gradually progressive diffuse conjunctival proliferation extending on the cornea was noted in 14 patients (28 eyes). These patients were followed up for a mean of 6 years for the site, extent, and progression of the condition. Six eyes had these lesions removed and studied histopathologically.


RESULTS
Patients included 6 men and 8 women (mean age, 57 years). Two patients had bilateral nasal lesions only, 1 patient had bilateral temporal lesions only, 6 patients had both nasal and temporal lesions, and 5 patients had lesions that extended circumferentially. Pathology reports showed dense collagenous tissue, a moderate number of active fibroblasts, numerous blood vessels, and no elastotic degeneration in 3 of the 6 eyes. Two eyes showed mild subepithelial elastotic degeneration, and 1 lesion was difficult to interpret because of excessive intraconjunctival hemorrhage. None showed any inflammatory activity.


CONCLUSIONS
The lesions appear to be a clinical variant of classic pterygium with the corneal encroachment being wider, irregular, and more extensive. Histologically, a noninflammatory nonelastotic collagenous accumulation appears to be a predominant feature unlike in classic pterygium where elastotic degeneration is the predominant feature.
Said
Dalia G
DG
Division of Ophthalmology and Visual Sciences, Queen's Medical Centre, University of Nottingham, Nottingham, England.
Mathew
Manu
M
Shaikh
M Yusuf
MY
Maharajan
V Senthil
VS
Lowe
James
J
Dua
Harminder S
HS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D049109:Cell Proliferation; D003229:Conjunctival Diseases / Q000175:diagnosis* / Q000601:surgery; D003316:Corneal Diseases / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D007839:Functional Laterality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011625:Pterygium / Q000175:diagnosis* / Q000601:surgery; D014786:Vision Disorders / Q000175:diagnosis; D014792:Visual Acuity