Abstract

Introduction: Primary acquired melanosis of conjunctiva(PAM) is an acquired pigmented lesion with potential to develop melanomas. Our case is unique being an extensive involvement of conjunctiva. An interventional study of 56 year old male with LE PAM with few elevated nodules amidst flat pigmentation, extending 340 degrees around limbus, cornea & limbal involvement from 1-8 clock hours, superior, temporal &inferior bulbar conjunctiva, superior & inferior fornix and palpebral conjunctiva of both lids with no extension to lid margins. Surgery done included corneal epitheliectomy, wide incisional biopsy with cryotherapy to the edges of the conjunctival under surface and to the areas un-excisable lesions, bare sclera covered with Amniotic membrane. Histo-pathology showed Conjunctival melanocytic intraepithelial Neoplasia (C-MIN score 4). After 6weeks postop, topical mitomycin C 0.04%eye drops was started with 1 week ON/OFF regimen for 4 weeks and advised follow up. Patient has 6/12 VA.