Conjunctival Intraepithelial Neoplasia (CIN)

Conjunctival Intraepithelial Neoplasia (CIN)
SYMPTOMS Discomfort | Irritation
SIGNS Gray-white gelatinous lesion(s) | Dilated vessels
WORK-UP Thorough history. Slit lamp examination
TREATMENT Interferon (IV or topical) | Topical mitomycin C | Topical 5-fluorouracil | Excision with biopsy
FOLLOW-UP Every few days during treatment
ADDITIONAL LAB | TESTS Consider biopsy
ETIOLOGY CIN has a number of causes and is likely multifactorial: Smoking | UV light | HPV | HIV, etc.
DIFFERENTIAL DX Pinguecula | Pterygium | Pannus | Conjunctival hemangioma
NOTES CIN is part of a broader spectrum of conditions under Ocular Surface Squamous Neoplasia (OSSN), which also includes corneal epithelial dysmaturation and SCC, among others | Interferon tx is not commonly available and must be compounded | Recurrence is common | CIN may be a precursor to SCC.
External hordeolum: infection of gland of Zeis or Moll
Association with dry eye syndrome and blepharitis.
Hordeola can develop into chalazion.

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