Concretions

Question 1

Aetiology

Answer 1

Small white/yellow lesions of the palpebral conjunctiva containing epithelial debris with mucinous secretions, sometimes with hard texture.

Question 2

Predisposing factors

Answer 2

Age - especially over 50s
Chronic inflammation such as chronic conjunctivitis, can sometimes be grouped around chronic chalazion

Question 3

Symptoms

Answer 3

Usually none
If eroded through conjunctiva, FB sensation, watering, redness.

Question 4

Signs

Answer 4

Well-defined white/yellowish bodies seen in tarsal conjunctiva (upper and/or lower), usually 1-2mm, can be larger if confluent, can be single or multiple, may stain with NaFl,

Question 5

Management

Answer 5

Usually none
If causing irritation, lubricants - drops during day, ointment before bed.
If eroded, they can be removed with minor surgery
- anaesthetic instilled, using sterile hypodermic needle to tease out lesions, applying finger pressure to stop bleeding (make sure not taking anticoagulants or aspirin), prophylactic antibiotic after surgery.