3o yrs /m , lesion since 4 days . No Rx done . No trauma. Vn - normal . Slight irritation. Dx & Rx ?


This case happens to be of 4days duration and with mild irritative symptoms.Since it is a mild case there is not actual pain.It is not a case of pterygium, pinguecula or phlycten.This is my impression.

There was some f.b sensation initially, but pain was not present.

Points against scleritis: Scleritis is associated with very severe pain and scleral edema...Here patient is mostly asymptomatic. To rule out phylectenular conjunctivitis..stain it with fluorescein dye... usually these nodules have epithelial defect at apex..which gets stained....moreover phylectenular conjunctivitis is also painful You can start NSAID eyedrop

Corneal phlycten is painful . Conjunctival phlycten is not so painful.

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Phlynectunular conjunctivitis

Nodular scleritis.Phlycten is unlikely at this age.

I have seen unequivocal phlycten in such young adults. Pain will be much more in scleritis.

Phlyctenular conjunctivitis

Since it is painless it can be nodular episcleritis. start with NSAID drops or a mild steroid like FML in tapering dose for a week.

Nodular Episcleritis, often associated with Rheumatic disorders, ulcerative colitis,Chron's disease etc etc. Recurrence is common and self-limiting too except a few

Inflamed pinguicula sir?


Ossn... Conj impression cytology Exicision biopsy with 3-4 mm margins and cryotherapy to edges

The size , shape, situation , slight Yellowish color, mild symptoms , acute onset & more frequency compared to ossn suggests it to be conjunctival phlycten. As I have seen the pt , I can say that it is an ulcerating phlycten.

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