Bilateral benign lymphoid hyperplasia of the conjunctiva in a paediatric patient

A 14-year-old boy presented with a 6-month history of bilateral slowly enlarging conjunctival lesions. There was no associated ocular or systemic symptomatology. Examination revealed bilateral salmon-coloured nodular lesions of the bulbar conjunctiva. The remainder of his ophthalmic and general examinations were normal. Extensive investigation excluded regional or systemic involvement. Excision biopsy of the lesions showed a predominantly mature B lymphocyte infiltrate with immunohistochemistry and flow cytometry consistent with reactive lymphoid hyperplasia. Polymerase chain reaction testing for Epstein-Barr virus was negative. At 2 years follow-up, the patient remained healthy and there was no evidence of recurrence. Benign lymphoid hyperplasia of the conjunctiva with bilateral involvement is extremely rare in children. Only a few case reports have been documented in the literature.