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Conjunctival Naevus

Eye Health
Ipoh Echo’s EYE HEALTH series continues with Consultant Eye Surgeon Dr. S. S. GILL talking to us about CONJUNCTIVAL NAEVUS.
Every now and then, there are patients who come in complaining of some patches of brown or grey on the white (conjunctiva) of their eyes. Well, most often than not, it will probably be a conjunctival naevus. Conjunctival naevus is a pigmented growth or lesion similar to a mole on your skin. It may be referred to as a “freckle in the eye.”
The word “naevus” has its origins from Latin. The Oxford dictionary defines it as a birthmark or a mole. Medically, a naevus may be found in the eye usually in the clear front white of your eye (conjunctiva), around the colored part of the eye (iris), or underneath the retina (nerve at the back of the eye). If the naevus is at the back portion of the eye (retina), it is called a choroidal naevus.
 
HOW DOES IT LOOK LIKE IN THE EYE?
Conjunctival naevus appears as a dark brown to black patch in the white of the eye (conjunctiva). The size of the patch may range from a small, barely noticeable patch, to a large patch that may cover a noticeable portion of the white of the eye (see adjacent picture).
 
CAUSES OF A CONJUNCTIVAL NAEVUS
A conjunctival naevus (pigmented growth) is produced by pigment cells called melanocytes. These are the same pigment cells which contribute to the colour of our skin, hair and eyes. These melanocyte cells are usually distributed evenly in the eyes, but when they form a cluster, it results in the formation of a conjunctival naevus.
 
SHOULD YOU BE CONCERNED?
Conjunctival naevus, although benign, should be periodically assessed with photographs taken at every check-up. This is to ensure that if it should ever start growing in size, it should be removed surgically. Sometimes there may be changes in colour and when this happens it should also be removed. This is because there is a small risk of the growth turning malignant and becoming a melanoma (cancerous). Thankfully, the risk of this happening is very low.
 
HOW IS IT TREATED?
There are no eye drops or medication available to treat conjunctival naevus. The only option for treatment is surgical removal.
 
Surgical excision is always done mainly for two reasons:
Cosmetic reasons – this is the commonest reason especially in cases where the growth is very dark or large, and appears unsightly to the patient.
Malignant (cancerous) transformation – this is the other reason that a conjunctival naevus growth is removed, that is, if it undergoes malignant transformation. In such instances, surgical removal is mandatory.
 
If you are in doubt about any pigmented lesions around the eye, do seek professional help.
 

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