AS-OCT in diffuse conjunctival lymphangiectasia.

Conjunctival chemosis is due to the presence of excess fluid in the conjunctival interstitium. It is caused by several conditions, including inflammation, allergy, infection, neoplasia, trauma, exposure, obstruction of lymphatic and venous outflow etc. This patient presented with unilateral diffuse non-resolving chemosis since one year. He had undergone extensive systemic investigations and imaging which were all negative and could not ascertain the cause of chemosis. An anterior segment optical coherence tomography (AS-OCT) confirmed the diagnosis as diffuse conjunctival lymphangiectasia. AS-OCT showed dilated lymphatic vessels as empty thin walled dark spaces of varying caliber in the sub-conjunctival space. Conjunctiva is elevated and thickened due to edema and the sclero-conjunctival interface can be visualized below. [Fig. 1] AS-OCT is a very useful non-invasive tool to confirm conjunctival lymphangiectasia.[1]

Figure 1

External (a) and slit lamp photos (b and c) showing chemosis and AS-OCT images (d and e) showing dilated lymphatic channels and conjunctival edema. Inset in d and e shows location of scans

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