Surgical treatment of conjunctival nevi in pediatric patients

Aim
To analyse histological evaluation findings in children with conjunctival pigmented lesions.

Material and methods
A retrospective medical record analysis of patients with conjunctival pigmented lesions treated between 2009 and 2018 was carried out. The patients (n=145; 87 males, 58 females) were aged 1 to 18 years (mean age of 10 years) underwent surgical treatment at the Department of Ophthalmology, at the Children’s Memorial Health Institute.

Results
Out of 146 analysed conjunctival lesions, 132 (90.41 %) were conjunctival nevi. Histological evaluation findings were melanocytic nevus (61 eyes, 41.78%), compound nevus (47 eyes; 32.19%), junctional nevus (23 eyes;15.75%) and subepithelial nevus (1 eye; 0.68%). The nevi were located in the bulbar conjunctiva (119 lesions, 81.51%) and lacrimal caruncle (27 lesions, 18.49%). The lesions found in the bulbar conjunctiva were usually located temporally (77 eyes, 64.71%) and nasally (42 eyes, 35.29%). In 14 cases (9.59%), the diagnosis of conjunctival pigmented lesion was ruled out with histology evaluation demonstrating inflammation (3 cases), inflammation with fibrosis (2 cases), melanosis (2 cases) as well as lentigo, subconjunctival haemorrhage, lymphangioma, haemangioma, severe conjunctival oedema with dilated lymphatic vessels, elevated melanocyte count and fibrotic connective tissue (one case of each).

Conclusions
Conjunctival lesions in children are mostly benign with conjunctival nevus being the most common finding of histological evaluation.