Posters

Tarsal plate palpebral conjunctival pigmentation due to chronic mascara usage

Poster Details

First Author: P.Mandal UK

Co Author(s):    H. Singh Mudhar   D. Cheung                 

Abstract Details

Purpose:

To describe a case of conjunctival pigmentation secondary to mascara use along with high quality clinical photography and high magnification histological slides.

Setting:

Ophthalmology Department, The Dudley Group NHS Foundation Trust, UK

Methods:

A 59 year-old lady attended for contact lens review and was found to have suspicious superior conjunctival pigmentation. This was subsequently referred to hospital eye services and a biopsy was taken.

Results:

Histology of the tarsal plate specimen showed a papillary reaction, which on further magnification showed chronic inflammatory cells at the papillary cores. There was foreign material that was black and particulate, clustering in small groups within the substantia propria of the conjunctiva. Immunohistochemistry showed that the black particulate matter was confined within macrophages. The appearances were consistent with mascara pigment within macrophages in the context of a chronically inflamed conjunctiva exhibiting papillary conjunctivitis. The patient was reassured and discharged from the oculoplastic clinic.

Conclusions:

There are only a few cases of cosmetic-induced conjunctival pigmentation in the literature, the first dating back to 1944. We postulate that the mascara pigment may be free floating in the tear film and encouraged by mechanical blink trauma, perhaps exacerbated by contact lens wear, is embedded into the palpebral conjunctiva. The deposition of pigment is linear and appears to correspond to the insertion of levator into the tarsus. This raises the question as to whether this area is more susceptible to repetitive mechanical trauma related to blinking and perhaps why contact lens related ptosis and involutional aponeurotic dehiscence occurs.

Financial Disclosure:

None