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 Table of Contents  
Year : 2017  |  Volume : 29  |  Issue : 3  |  Page : 256

Reply: Pigmented ocular surface squamous neoplasia

Anterior Segment Services, Aradhana Eye Institute, Thiruvananthapuram, Kerala, India

Date of Web Publication30-Jan-2018

Correspondence Address:
Philip Kuruvilla
Anterior Segment Services, Aradhana Eye Institute, Thiruvananthapuram, Kerala
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/kjo.kjo_103_17

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How to cite this article:
Kuruvilla P, Kuruvilla AG. Reply: Pigmented ocular surface squamous neoplasia. Kerala J Ophthalmol 2017;29:256

How to cite this URL:
Kuruvilla P, Kuruvilla AG. Reply: Pigmented ocular surface squamous neoplasia. Kerala J Ophthalmol [serial online] 2017 [cited 2019 Sep 21];29:256. Available from: http://www.kjophthal.com/text.asp?2017/29/3/256/224283

Dear Sir,

We thank Drs. Chauhan and Sharma for their interest in our article. We agree with all the additional points which they have meticulously mentioned toward working up of a case of malignant ocular surface squamous neoplasia (OSSN).

We accept that all the negative findings on history and examination pertaining to the topic of concern were not included in the manuscript though undertaken. The decision to exclude certain investigations or to highlight certain positive findings was largely based on the extent of relevance in dealing with the specific case at hand.

Ultraviolet (UV) rays have undoubtedly been a strong risk factor in developing OSSN.[1],[2],[3] Older age group (average 56 years), male sex, and geographic location closer to the equator (with regard to ambient solar UV-B radiation) are documented risk factors which are all the more significant when combined together.[4],[5] Our patient was a 58-year-old healthy Indian male, working long hours outdoors in a middle Eastern country, with a limbal lesion in the sun-exposed interpalpebral area. This, in addition to the negative history of high-risk behavior in this patient, prompted us not to test for HIV at the time. The dermatological examination was done and was unremarkable.

The case we presented was a carcinoma in situ (conjunctival intraepithelial neoplasia III),[6] a form of preinvasive OSSN, in which dysplastic cells are restricted up to the basement membrane of the epithelium.[7] The substantia propria in these cases is free of tumor, therefore, eliminating the risk of metastasis. Had this been an invasive squamous cell carcinoma, further investigations would have been deemed necessary.

Financial support and sponsorship

This study was financially supported by Aradhana Eye Institute, Thiruvananthapuram, Kerala, India.

Conflicts of interest

There are no conflicts of interest.

  References Top

Erie JC, Campbell RJ, Liesegang TJ. Conjunctival and corneal intraepithelial and invasive neoplasia. Ophthalmology 1986;93:176-83.  Back to cited text no. 1
Lee GA, Williams G, Hirst LW, Green AC. Risk factors in the development of ocular surface epithelial dysplasia. Ophthalmology 1994;101:360-4.  Back to cited text no. 2
Clear AS, Chirambo MC, Hutt MS. Solar keratosis, pterygium, and squamous cell carcinoma of the conjunctiva in Malawi. Br J Ophthalmol 1979;63:102-9.  Back to cited text no. 3
Lee GA, Hirst LW. Ocular surface squamous neoplasia. Surv Ophthalmol 1995;39:429-50.  Back to cited text no. 4
Newton R. A review of the aetiology of squamous cell carcinoma of the conjunctiva. Br J Cancer 1996;74:1511-3.  Back to cited text no. 5
Kuruvilla P, Kuruvilla A. Pigmented ocular surface squamous neoplasia. Kerala J Ophthalmol 2017;29:51-3.  Back to cited text no. 6
  [Full text]  
American Academy of Ophthalmology. Basic and Clinical Science Course 2013-2014. Section 8. Singapore: American Academy of Ophthalmology; 2013;8:228.  Back to cited text no. 7


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