Corneal Intraepithelial Neoplasia

Translucent gray area of subtle conneal intraepithelial neoplasia involves 40% of the superior cornea. Retroillumination view of the same lesion demonstrates an irregular border of the progressive corneal involvement separating the abnormal from the normal corneal epithelium. 

  • A rare, unilateral premalignant condition
  • More commonly seen in older, fair-skinned individuals
  • Usually occurs as a localized, slightly elevated, minimally invasive, and remains confined to the epithelium
  • May infrequently invade the underlying stroma and metastasize to regional lymph nodes
  • Recurrences are common

Clinical features:

  • Nodular, or irregular white lesions (leukoplakia) that may occur anywhere in the conjunctiva or cornea, most commonly at the limbus in interpalpebral fissure
  • Fleshy or frothy vascularized lesions that simulate benign conjunctival squamous papilloma
  • Diffuse, translucent gray area of conjuctival intraepithelial neoplasia involving the cornea

Management:

  • Surgical excision with cryotherapy and/or alcohol application
  • Use of topical chemotherapy with mitomycin C, 5-fluorouracil, or interferon