Eyelids & the Anterior Segment:
                Case thirty three

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This 52 year-old man developed this lesion three weeks after an operation for a right pterygium.

a. What is the diagnosis?

Pyogenic granuloma.

The picture shows a raised red lesion arising from the site where the pterygium had been excised. This condition is typically seen at areas of inflammation or after surgery or trauma. In the eye, it is seen mainly on the eyelids and the conjunctiva and results from exaggerated healing process. It is painless.

b. What would the histology of the lesion show?

Histologically, the lesion shows granulation tissue with proliferating capillaries and endothelial cells.

c.  How would you manage this condition?

The patient should be reassured about the benign nature of this lesion. The lesion can be treated as follow:

• Conservative. No treatment may be needed as the natural history is for the lesion to resolve spontaneously. However, as the lesion is in an obvious site this may not be acceptable to the patient.
• Topical steroid. This can speed up resolution of the lesion.
• Local excision.