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Kiire and Dhillon draw attention to the surge in cases of conjunctival neoplasia,1 but do not make clear that this has occurred mostly in sub-Saharan Africa—in Uganda, for example, the reported incidence has more than tripled over the past decade.2,3 HIV infection leads to a roughly 10-fold increase in the risk of conjunctival neoplasia, and in Africa, most people with conjunctival neoplasia are HIV positive.4–8 In a recent study of 414 cases in Uganda, 64% of people with conjunctival neoplasia were HIV positive; this applied to intraepithelial and invasive cases.9 Ophthalmologists in Western countries may see …
Competing interests: None.
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