Fibrous Histiocytoma Of The Corneoscleral Limbus

Abstract

In June 1968, a 3-year-old black girl was seen in the Children's Eye Clinic at the Edward S. Harkness Eye Institute on referral with the diagnosis of a granuloma of the right eye. There had been a swelling at the right corneoscleral limbus for a period of three months. The child had an unremark­ able birth and development, but was found to have hemoglobin A F disease. Two years previously she had had a febrile convulsion and was unconscious for four days. Her history indicated that she de­ veloped cortical blindness and left hemiparesis after the seizure, perhaps due to a vascular accident. There was slow but progressive improvement of vision with the ability to pick up small objects. At the Eye Institute, the ophthalmologist could not evaluate the patient's vision because of her inability to play the E game, but he felt that she could see the objects presented to her. He found a 4 X 4-mm tan-pink elevated mass at the 7-o'clock position of the right corneoscleral limbus with a prominent feeder vessel. The lesion involved the peripheral cornea (Fig. 1) . There was no pupillary abnormality, and the refractive error was 1.50 + 4.S0 X 90 in the right eye and 1.50 + 3.50 X 90 in the left eye. The eye grounds and optic nerve heads were normal. Evaluation of the orbit and skull disclosed a slight enlargement of the right optic canal. When seen in the neurologic clinic at Columbia Presbyterian Medical Center, she was found to have a mild left hemiparesis. On returning to the Eye Clinic two months later the mother felt that the limbal lesion had definitely thickened, although objective examination failed to confirm any enlargement or change in the feeder vessel. The patient was admitted to the hospital for surgical removal of the mass. A small lamellar keratectomy was performed. In follow-up during the year after the operation