Fig. 1: The spectrum of clinical presentations.

a Case 9 showing diffuse red conjunctiva, corresponding histologically to in-situ carcinoma. The arrow indicates a subtle red thickening of the inferior tarsal conjunctiva, indicating the site of the invasive tumour. b Case 11. The medial scarring is from previous surgical excision with graft. The new invasive tumour is indicated by the arrow, showing lid margin white thickening and a raised red tarsal conjunctival area. c Case 10 showing a fleshy red, nodular gelatinous lesion over the medial bulbar conjunctiva with plica semilunaris involvement. d Case 8 showing a papillomatous, gelatinous mass with eyelid margin involvement in the inferotemporal forniceal and tarsal conjunctiva. e Case 7 showing a large, multinodular mass with erythematous base and surface leukoplakia involving the inferior tarsal and forniceal conjunctiva.