Buchwald H.-J., Müller A., Spraul C. W., Lang G. K.

University Eye Hospital and Clinic, Prittwitzstrasse 43, D-89075 ULM, FRG

The value of ultrasound biomicroscopy in the diagnosis of conjunctival lesions is not well known.
Method: To study conjunctival lesions, we used an ultrasound biomicroscope (Humphrey, Zeiss, Oberkochen) with high frequency sound heads (30 and 50 Hz). Included in this study were all patients with conjunctival lesions, which were consecutively operated on between January 2000 and May 2001. The results of the ultrasound biomicroscopy examination were correlated with light microscope findings of these lesions.
Results: Seventeen patients (9 female, 8 male) with a mean age of 49.5 years, range 9 to 72 years were available for this study. Histologic examination displayed cysts (4/17), compound nevus (3/17), epithelial cysts (2/17), a granulomatous process (2/17), lymphoma (2/17), a foreign body (1/17) and a conjunctival amyloidosis (1/17). Using ultrasound biomicroscopy we were able to demonstrate a cystic tumor in the six patients (35%) with a cyst of the conjunctiva. In patients showing solid tumors of the conjunctiva the definite diagnosis could not be differentiated with ultrasound biomicroscopy alone. The three patients with compound nevus displayed a somewhat heterogenous sonographic structure within the tumor. In the patient with a foreign body we were able to demonstrate posterior shadowing of the underlying tissue.
Conclusion: For evaluation of conjunctival lesions caused by a cyst or a solid tumor, ultrasound biomicroscopy may be an additional diagnostic tool, e.g. for assessment of the margins of the tumor. However, up to now it is not possible to differentiate different lesions solely on ultrasonographic findings.

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