
A 12-year-old boy presented to the clinic for a routine ophthalmologic checkup. During the examination, a small, dark lesion was observed on the bulbar conjunctiva of his left eye. He did not complain of any ocular symptoms and mentioned that the dark lesion had been there for the past 2 years. He denied taking any medications and he did not have any systemic symptoms.
His visual acuity was 20/20 in both eyes. Slit lamp examination revealed a sesile, brownish, elevated lesion with clear cysts located at the temporal interpalpebral conjunctiva, very close to the limbus. Pupils, extraocular movements, intraocular pressure, and results of fundoscopy were normal. The patient indicated that the lesion had not grown in the past 2 years and that he had not noticed any change in colour. The patient was otherwise healthy.
The most likely diagnosis is
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Conjunctival melanoma
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Conjunctival nevus
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Primary acquired melanosis
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Pterygium
Answer on page 1159
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