Chemo-adjuvant therapy in recurrent conjunctival intraepithelial neoplasia

A 68-year-old Malay male with no known medical illness presented with progressive growth of right conjunctival mass over a few months. Anterior segment examination of the right eye showed an inferior perilimbal elevated gelatinous conjunctival mass measuring 6 mm vertically x 14 mm horizontally with 360° corneal vascularisation. Excision biopsy and histopathological examination revealed areas of dysplastic cells involving the full epithelial thickness, suggestive of conjunctival intraepithelial neoplasia. The patient defaulted follow-up and presented later with recurrence involving the superior two-thirds of the cornea. Pulsed dosing of topical 5-fluorouracil 1% was initiated 4 times daily for a week with 21-day breaks for a total of 4 cycles. Regression of the lesion was noted after two cycles of 5-fluorouracil.