AN UNUSUAL CASE OF ELASTOFIBROMA OCULI

A 22-year-old female college student from the southwestern United Stat es was First seen with progressive fluffy white growths over both corn eas nasally and a history of chronic allergies and extensive sun, wind , and chlorine exposure as a competitive swimmer. The lesions were sup erficial, elevated, crescent-shaped, vascularized, and extended from t he limbal conjunctiva onto the peripheral cornea nasally. The lesions were composed of an unencapsulated thick fibrovascular pannus with num erous fibrocytes, chronic inflammatory cells and mast cells, and abund ant linear and wavy elastinophilic profiles, but no adipose tissue. Ul trastructurally. the elastinophilic structures were immature elastic f ibers arranged in globules and bundles within a thick collagenous matr ix. No mature elastic fibers were found. A few areas of elastotic dege neration were also found. This lesion resembled elastofibromas that ha ve been reported more commonly in the subcapsular region and only once in the ocular region. Previous reports debated whether the elastic ma terial in elastofibromas is derived from excessive production of elast ic fibers by activated fibrocytes or from elastotic degeneration of co llagen. In our case, both processes occur and are presumed to result f rom excessive ultraviolet radiation, wind and chlorine exposure, and p erhaps, chronic inflammation; features that have been ascribed to the pathogenesis of pingueculae and pterygia.