This may be normal racial variation, a benign naevus or conjunctival melanoma
Clinical Features
Conjunctival pigmentation is commonly seen in dark skinned people. It is bilateral, patchy, flat and stable
Benign conjunctival naevi are similar to skin moles. They tend to appear in early adult life when they may enlarge and become darker. They are solitary, well-defined and usually almost flat
Conjunctival melanoma usually presents in the 50-60s. There may be pre-existing pigmentation (primary acquired melanosis, or rarely a naevus). Most are solitary enlarging lumps with pigmentation varying from dense to minimal
Management
Racial conjunctival pigmentation does not need any ophthalmic referral
For any other pigmented conjunctival lesions see ophthalmologist
