Ocular surface neoplasia masquerading as chronic blepharoconjunctivitis

Purpose. To present the clinical characteristics and difficulties in the di agnosis of various ocular surface malignancies mimicking features of chroni c blepharoconjunctivitis and to summarize the current therapeutic approach and prognosis of patients. Methods. Six patients with slowly evolving signs of persistent inflammation underwent a conjunctival biopsy after a prolong ed course of medical treatment. The medical records of the patients were re viewed. Results. Histopathologic examination of the biopsy specimens reveal ed intraepithelial squamous neoplasia (one patient), invasive squamous cell carcinoma (one patient), sebaceous carcinoma (two patients), and conjuncti val lymphoma (two patients). Conclusion. Although uncommon, ocular surface malignancies may involve the conjunctiva diffusely and present as chronic c onjunctivitis. A high index of suspicion and an early histopathologic exami nation are essen tial to not delay diagnosis.