Case 3

Quiz Challenge August (iii)

Quiz Challenge August (iii)

Dr Charles Su


This eye has an abnormality in the conjunctiva. What are the features which you notice, and what serious diagnosis needs to be investigated for?

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There is a pink elevated patch of conjunctiva medial to the cornea. It is not pink from vascular dilation but there appears to be abnormal tissue which has the “salmon” colour. Nor is the elevation suggestive of simple oedema (chemosis), which is not discoloured. This is an example of a salmon patch in the conjunctiva, which is a deposit of lymphoma. These can be the first presentation of lymphoma, and hence, conjunctival changes which are not definitely typical of pingueculae or pterygia in appearance, or which have a shorter history of onset and progression, must be evaluated, with a biopsy and histology, if need be.