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A 74-year-old woman consulted for bloody tears. The etiology was a large conjunctival nodular melanoma hidden in the left superior fornix that had developed quietly on an unknown primary acquired melanosis. In this report the clinical and histological features as well as the treatment are presented. A decisional tree summarizes the treatment for conjunctival melanosis.

A 28-year-old male patient had a chalazion on his left eyelid. Increased discomfort led to the discovery of a conjunctival mass under the inner part of his upper eyelid. On clinical examination, a small reddish mass on the palpebral conjunctiva of the upper left eyelid was only visible on the underside of the lid; the mass was diffusely reddish. Additionally, a chalazion was present in the middle of the lower left eyelid. As this condition was a source of discomfort to the patient, the mass was surgically resected. The histological study found a typical pyogenic granuloma, a possible complication in the course of a chalazion.

A 6-year-old girl exhibited a recent caruncular tumor which was increasing in size. It was removed after a CT scan had showed a both medial and superficial mass. Fortunately, histological tests only found inflammatory cells attesting that the mass was due to an inflammation of this area. Inflammation is one of the different processes that may increase the size of the caruncle, but sometimes, only histopathology can provide conclusive evidence.

An 18-year-old female patient developed a mass in the superomedial angle of her left orbit. After evaluation, this tumor was surgically removed. A dysembryoplastic cyst lined with conjunctival epithelium was diagnosed by light microscopic examination. Clinical and pathological data are detailed. The characteristics of dysembryoplastic orbital cysts are reviewed.

A primary acquired melanosis occurred in the right bulbar conjunctiva of a 65 year-old caucasian woman. After four years of steadiness, this lesion gave raise to a malignant conjunctival melanoma. The evolution remained under control three years after the end of the therapeutic procedures. Clinical and histopathological data are presented.

A clinico-pathologic case of a pyogenic granuloma is reported in a 34-year-old male patient. Clinically, a nodular painless reddish tumour with a fibrinous membrane covered top, developed at the right caruncle. After surgical excision, the histopathological study established the diagnosis of a pyogenic granuloma, partially covered by a conjunctival epithelium, and a fibrinous membrane at its top.

Conjunctival cystic lesions are not uncommon and may arise anywhere in the conjunctiva, although the inferior fornix is one of the most frequent sites. We report the case of a 5 year-old-male black patient who underwent surgical excision of an unusually large conjunctival cyst of the inferior left fornix. The histopathological study showed that the cyst border was lined by a conjunctival epithelium, consistent with a conjunctival inclusion cyst.

A new case of conjunctival allergic nodule is reported in a Guinean man. This lesion was first described by Ashton and Cook in 1979. Histologically, this nodule consists of amorphous eosinophilic material surrounded by epithelioid and giant cells arranged in a pallisade; some eosinophils are often found in the inflammatory reaction. This lesion usually resolves spontaneously. In documented cases, nematodes and particularly filaria such as Mansonella perstans are usually isolated. Our observation is the first documented case with Onchocerca volvulus. Microfilariae were detected by examination of normal saline containing the biopsy specimen. The new major antifilarial treatment ivermectin was associated.

Benign diseases of the cornea and conjunctiva can in fact be found in all chapters of pathology. Inflammatory diseases are by far the most common, with a predominance of viral infections, notably herpes corneae the long-term prognosis of which is not always favourable. Other benign diseases are injuries, dystrophies, overloads and finally tumours. All these diseases are briefly described in this article.