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This paper reviews a personal experience of 51 cases seen over a 30 year period. Patients were treated in either a combined Head and Neck clinic or a Combined Ophthalmology clinic and a balanced view is thus represented. A method of grading the severity of the disease is described as well as a method of assessing response. This approach has not been proposed hitherto. It is generally concluded that the preferred treatment for small lesions is excisional surgery and for larger lesions carefully planned and highly localized radiation.