Figure 1

Left eye conjunctival lesion noticed 4 months prior to referral to the oncology clinic after treatment with topical steroids failed. Slit lamp photographs reveal a vascularised cream-coloured lesion (A). Nasally, the lesion appeared to arise from the epithelium with two small pearl lesions consistent with leukoplakia while the temporal aspect was mainly subconjunctival. Optical coherence tomography revealed thickened epithelium with invasion into the subconjunctival space (B). Photomicrgraph of H&E-stained slide of conjunctival invasive squamous cell carcinoma. The neoplastic epithelium is much thicker than the peripheral non-neoplastic epithelium, and exhibits disordered maturation toward the surface (C). At the right, the carcinoma is seen undermining the non-neoplastic conjunctival epithelium (original magnification ×31). The inset depicts a higher-power photomicrograph, wherein the atypical cytologic and architectural features as well as the irregular, invasive stromal interface characteristic of squamous cell carcinoma, are more easily observed (original magnification ×180)