Diffuse keratoconjunctival proliferation: a novel clinical manifestation

Arch Ophthalmol. 2008 Sep;126(9):1226-32. doi: 10.1001/archopht.126.9.1226.


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.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cell Proliferation
  • Conjunctival Diseases / diagnosis*
  • Conjunctival Diseases / surgery
  • Corneal Diseases / diagnosis*
  • Corneal Diseases / surgery
  • Female
  • Functional Laterality
  • Humans
  • Male
  • Middle Aged
  • Pterygium / diagnosis*
  • Pterygium / surgery
  • Vision Disorders / diagnosis
  • Visual Acuity