A Case Of Three Isolated Nonvascularized Corneal Epithelial Dysplasia Lesions In A Middle Aged Woman

To report a case of three isolated nonvascularized corneal epithelial dysplasia lesions surrounded by normal corneal epithelium. 

Epithelial dysplasia is a precancerous lesion and is categorized as conjunctival/corneal intraepithelial neoplasia. The pathogenesis of the lesion usually commences at the limbus and grows towards central cornea. It is usually associated with neovascularization. 

A 49-year-old woman consulted us for sudden foreign body sensation with localized opacification of the corneal epithelium in her left eye. Her visual acuity was 20/20 in both eyes. Slit lamp examination showed three whitish plaque-like lesions at the center of her right corneal epithelium. No vascular invasion to the lesions was found.  Anterior segment optical coherence tomography showed hyperreflective, thickened epithelium. The lesions were easily peeled off from the underlying basement membrane. After corneal abrasion the lesions reoccurred 7 days later. Then they were surgically removed and subjected to histopathological examination and diagnosed as epithelial dysplasia, whereas the limbal and conjunctival biopsies showed normal epithelium. After the second intervention the cornea remained clear with good vision.

The three lesions were diagnosed as nonvascularized epithelial dysplasia of ocular surface. Etiology of these lesions is not known.