Subepithelial Lesions of the Ocular Surface: A Review

Subepithelial lesions of the ocular surface represent a diverse group of pathologies which may be difficult to diagnose clinically. Some of these lesions are relatively uncommon, may result in systemic manifestations, or occur secondary to systemic disease. The purpose of this review is to summarize current approaches to the diagnosis and management of six subepithelial conjunctival lesions.

The standard for the diagnosis of subconjunctival lesions remains histopathologic evaluation; however, high-resolution anterior segment optical coherence tomography (HR-OCT) is a useful supplemental diagnostic tool that may facilitate diagnosis. Recent advancements in the management of subconjunctival lesions include targeted systemic therapies in conjunctival melanoma and ultra-low dose radiation radiotherapy in conjunctival lymphoma.

The development of HR-OCT has provided clinicians with valuable supplemental diagnostic information to guide the diagnosis of subepithelial lesions. Additionally, novel treatment modalities may provide an alternative to traditional surgical interventions in some pathologies.