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Amniotic membrane transplantation and excision may treat occupationally acquired conjunctival melanosis after exposure cessationRemoving tissue and transplanting membrane helps treat eye discoloration

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Key Takeaway
Consider removing the causative agent and using amniotic membrane transplantation for persistent occupationally acquired melanosis.

This case report and review of literature describes a 40-year-old Han Chinese male with conjunctival melanosis linked to exposure to airborne organic compounds, specifically phenylenediamine. The report highlights that pigmentation showed partial improvement at 3 months and decreased substantially after 1 year following the cessation of exposure. Histopathology of the excised tissue showed increased melanocytes within the conjunctival epithelial basal layer without atypia, confirming a benign reactive process.

The authors suggest that occupationally acquired conjunctival pigmentation may resolve progressively once the causative agent is removed. For patients presenting with persistent lesions or specific cosmetic concerns, the combination of selective excision of the pigmented conjunctiva and amniotic membrane transplantation is presented as an effective treatment strategy.

A primary limitation of this evidence is the small sample size and the lack of extensive clinical reports for this specific condition. The certainty of these findings is low due to the single case report nature of the primary data. Clinical application should be approached with caution given the limited data available for this specific condition.

Imagine looking in the mirror and seeing dark, discolored patches on the white part of your eye. For a 40-year-old man, this wasn't just a cosmetic issue. It was caused by his work involving chemicals called phenylenediamines. This type of eye discoloration, known as conjunctival melanosis, can be stubborn and persistent.

Doctors treated him by removing the discolored tissue and replacing it with an amniotic membrane. They also had him stop using the chemicals that caused the problem. At the three-month mark, his eye showed some improvement. By the one-year mark, the dark spots had decreased substantially.

While this specific case is just one example and the evidence is limited, it shows that surgery and avoiding the cause can work. The tissue they removed was found to be a harmless reaction to the chemicals, not a dangerous growth. Talk to your doctor if you notice any unusual changes or spots on your eyes.

What this means for you:
Surgery and avoiding chemical exposure can significantly reduce dark spots on the eye's surface.

Common questions

What caused the dark spots on the patient's eye?

The patient's eye discoloration was linked to his exposure to airborne organic compounds called phenylenediamines. These chemicals are often used in industrial processes. The study suggests that these specific chemicals are likely responsible for the dark spots on the conjunctiva, which is the clear membrane covering the white part of the eye.

Was the dark tissue on the eye cancerous?

No, the tissue was not cancerous. A microscopic examination of the removed tissue showed that the cells were part of a benign, or non-cancerous, reaction to the chemicals. The study confirmed that the growth was a reactive process rather than a malignancy.

How effective was the surgery and treatment?

The treatment showed good results over time. The patient's eye showed partial improvement at three months. By the one-year follow-up, the dark pigmentation had decreased substantially. This happened after the patient underwent a procedure to remove the tissue and stopped being exposed to the chemicals.

Study Details

Study typeSystematic review
EvidenceLevel 1
PublishedSep 2026
View Original Abstract ↓
Conjunctival pigmentation is a multifactorial condition that may be associated with occupational exposure to airborne organic compounds, but clinical reports of such cases remain limited. A 40-year-old Han Chinese male presented with scattered black deposits on the conjunctiva and lacrimal caruncle after prolonged occupational exposure to airborne organic compounds (phenylenediamine) without personal protective equipment. He was advised to avoid further exposure. At the 3-month follow-up, the pigmentation in both eyes had partially improved. The patient requested surgical treatment for cosmetic concerns in one eye; selective excision of the pigmented conjunctiva combined with amniotic membrane transplantation was performed, achieving satisfactory outcomes. The contralateral eye was kept under observation, and after 1 year of continued avoidance of exposure, the pigmentation in the unoperated eye had further decreased substantially. Histopathology of the excised tissue revealed increased melanocytes within the conjunctival epithelial basal layer without atypia, confirming a benign reactive process and excluding malignancy. Occupationally acquired conjunctival pigmentation may partially and progressively resolve after removal of the causative agent. For patients with persistent lesions or cosmetic requests, partial conjunctival resection combined with amniotic membrane transplantation can be an effective treatment option.
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