Ocular Surface Squamous Neoplasia (OSSN)

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Also called Conjunctival Epithelial Neoplasia (CIN), Dysplasia, Squamous Cell Carcinoma Ocular Surface Squamous Neoplasia (OSSN) is a rare, unilateral premalignant condition. It is similar to skin cancer on the eye surface. It is most commonly found in older white males (75%). It is related to sun exposure throughout life. Sunlight, particularly ultraviolet-B (UV-B) radiation can cause DNA damage, mutations, and cancerous cells. Fair skinned people are more at risk. Human papillomavirus 16 has been found in conjunctival tumor specimens, although it has not been proven to cause this tumor.

Symptoms Patients notice a white or yellow-white lump on the surface of the eye (often with extension onto the cornea). There may be associated large blood vessels or inflammation.

Diagnosis The diagnosis of Ocular Surface Squamous Neoplasia (OSSN) is typically made by biopsy. Impression cytology is an office test that may help to make the diagnosis.

Treatments Topical chemotherapy, or "chemotherapy eye drops" have been found effective in several clinical trials. These have included: mitomycin C, 5-fluorouracil, or interferon.

Surgical excision with cryotherapy is also effective, and is usedwhen the drops don’t work, or for small, localized lesions.
Recurrence Recurrences are common. This may occur within weeks, or even 10 years after primary treatment, therefore regular follow-up exams at least annually are recommended.