A Conjunctival Pannus Simulating A Carcinoma In Situ A Case Report

to report the case of a patient who presented with a conjunctival pannus or superficial chronic conjunctivitis and superficial punctate keratitis as part of a surface pathology initially mistaken for a carcinoma in situ.

Department of Ophthalmology. A 62-year-old female patient with history of diabetes , presenting with blured vision  and referred to our department for further management of a corneal lesion initially mistaken for a corneal conjunctival carcinoma in situ in the rghit eye

a 62-year-old diabetic patient referred to our department for further management of a corneal lesion initially mistaken for a corneal conjunctival carcinoma in situ in the rghit eye. On examination, her visual acuity was limited to 6/10 in the right eye and 8/10 in the left eye. The anterior segment examination revealed severe meibomitis, superficial keratitis, and peripheral superficial corneal opacity on the right eye with both superficial and deep corneal neovascularization. Intraocular pressure was 16 mm Hg bilaterally, and the fundus examination was normal. Our management approach included doxycycline 100 mg/day, a 0.5% cyclosporine eye drop preparation at a dose of 3 drops/day, and a subconjunctival injection of bevacizumab targeting the corneal neovascularization. The follow-up showed resolution of ocular redness, superficial punctate keratitis, regression of corneal neovascularization, and improvement of corneal opacity.

Conjunctival pannus or chronic superficial keratitis is a corneal erosion of very varied causes, characterized by scattered punctate micro-lesions of the corneal epithelium. A localized limbal insufficiency, as part of an ocular surface pathology, can present as a pannus that can mistakenly simulate a localized conjunctival tumor.