Oculoplastics · practice question
How should this change be interpreted?
A teenager's known conjunctival nevus becomes more pigmented and slightly larger around puberty; it still contains visible cysts and has smooth borders. How should this change be interpreted?
Show the answer and explanationAnswer and explanation
Answer: A. Expected hormonal change in a benign nevus
Conjunctival nevi commonly darken and enlarge slightly at puberty while retaining benign features (cysts, smooth borders) — an expected hormonal change, not malignancy. Loss of cysts, new feeder vessels, or nodularity would instead prompt biopsy.
Clinical pearl: Documenting the lesion with photographs at baseline lets these expected pubertal changes be distinguished from genuinely worrying growth later.