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A 59 year old international travel journalist presented with a four month history of a red, painless eye. Examination showed conjunctival injection of the right eye, with fern-like vessels extending onto the cornea. Excision biopsy confirmed squamous intraepithelial carcinoma. Topical 5-fluorouracil and cryotherapy was given to minimise the risk of recurrence.
Risk factors include exposure to sun, human papilloma virus infection, and HIV infection. It is the most common neoplasia of the conjunctivae, with a high incidence of local extension and recurrence. It should be considered in any patient with persistent conjunctival injection, especially if unusual vascular patterns are seen.seen.