[Allergic granulomatous nodule of the conjunctiva]

Six cases of conjunctival allergic granulomatous nodules are reported. This benign lesion was described by Ashton and Cook in 1979. It is commonest in children and young people. Clinically it consists of one or more raised yellow nodules beneath the epithelium of the bulbar conjunctiva. Histologically these nodules consist of an amorphous eosinophilic material surrounded by epithelioid and giant cells arranged in a palisade; often some eosinophils are found in the inflammatory reaction. In the absence of surgical intervention these lesions can disappear spontaneously or after corticotherapy in a few weeks or months. According to Ashton and Cook these granulomas show the histologic feature of the Splendore Hoeppli phenomenon, that is, a giant cell and eosinophilic granulomatous reaction to an antigen-antibody precipitate in relation to parasite or fungi. In two cases Ashton and Cook found fragments of nematode larvae but usually no foreign bodies or parasites are identified in the lesions.