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Snapshot diagnosis - what's wrong with this eye?

Dr Mike Wyndham shares another uncommon diagnosis from his case files

Dr Mike Wyndham shares another uncommon diagnosis from his case files

The patient

This 62-year-old man presented with a red swelling growing out of his eye. It had been getting bigger during the past year and his family had urged him to get it checked. Reluctantly, he attended as it was causing him some irritation.

First instinct

I thought it was some sort of benign lesion, as it appeared to be soft. I suspected a vascular lesion, possibly a haemangioma, although it did not appear to be blood-filled.

Differential diagnosis


•Pyogenic granuloma

•Some type of malignancy

The hidden clue

Haemangiomas, papillomas and pyogenic granulomas generally have a limit on their size and this lesion was continuing to grow. It was also somewhat irregular, whereas the aforementioned lesions tend to be smooth. Perhaps the most likely diagnosis was a localised cancer.

Getting on the right track

When you come across an uncommon lesion, you may need help in making the diagnosis and I was very much in this situation. The ophthalmologist was much more confident when she saw him and felt this was a conjunctival carcinoma.

Outcome and treatment

The lesion was excised and confirmed as a conjunctival carcinoma. He was asked to instil interferon-alpha eye drops for a period of three months. There has been no recurrence of the tumour.

Dr Mike Wyndham is a GP in Edgware, north London

What's wrong with this eye?

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