This guideline last updated 06/05/2022 17:41:11

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