Date of last review: Due to be updated

Differential diagnosis

Lid lesion:

  • Basal cell carcinoma
  • Neurofibroma
  • Sebaceous adenoma
  • Non- pigmented intradermal naevus
  • Squamous cell papilloma
  • Chalazion
  • Cutaneous horn
  • Sebaceous carcinoma

Follicular conjunctivitis:

  • Herpes simplex
  • Adenovirus
  • Chicken pox
  • Chlamydia
  • Topical medication (conjunctivitis medicamentosa)
  • Parinaud’s oculo-glandular syndrome

Possible management by Optometrist

Treatment

  • Artificial tears and lubricating ointment may relieve symptoms in follicular conjunctivitis
  • Antiviral agents ineffective
  • Active intervention for lesions of the lid margin causing follicular conjunctivitis

Advice

  • Lesion usually self-limiting (weeks or months) without sequelae
  • Advise on need for hygiene to prevent reinfection and spread to others

Management Category

  • Normally no referral
  • Routine referral to ophthalmologist if:
    • Multiple peri-ocular lesions
    • Lesions on the lid margin
    • Follicular conjunctivitis

Possible management by Ophthalmologist

  • Incision and curettage