The conjunctiva is covered by specialised squamous epithelium containing mucus-secreting cells. The specialised epithelium is on the posterior aspect of the eyelids and covers the eye to the limbus, where it becomes entirely squamous epithelium to cover the cornea.

Figure 20.2. Wedge resection of eyelid.

The common lesions of the conjunctiva are:

pinguecula, pterygium. naevi, malignant melanoma, extrinsic, e.g., injury.

3. Inflammatory: not usually biopsied but may be scraped for diagnosis of trachoma or other parasite infection. basal cell carcinoma, squamous cell carcinoma, malignant melanoma.

1. Degenerative:

2. Pigmented:

4. Malignancy:

The purpose of conjunctival biopsies is usually diagnostic ± cosmesis. As with eyelid biopsies, an assessment of the limits of excision may be of importance but usually the presence of infiltrating tumour in a biopsy from the fornix of the conjunctiva is sufficient justification for more radical treatment.

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