Imaging of Ocular Surface Lesions Using Anterior Segment Optical Coherence Tomography

Ocular surface lesions encompass a wide spectrum of entities ranging from benign degenerative lesions to non-invasive and invasive malignant tumours. Accurate clinical differentiation is essential to ensure timely management. In this manuscript, we describe a series of benign and malignant ocular surface lesions and their clinical and specific imaging findings on anterior segment optical coherence tomography (AS-OCT), highlighting the diagnostic utility of this non-invasive imaging modality. We characterise ocular surface squamous neoplasia, pterygia, Salzmann's nodular degeneration, conjunctival melanoma, primary acquired melanosis, conjunctival nevus, conjunctival lymphoma, benign reactive lymphoid hyperplasia and conjunctival amyloidosis. This series underscores the growing role of AS-OCT in supporting clinical assessment, guiding biopsy decisions and monitoring response to therapy in patients with ocular surface lesions. Its integration into routine practice offers a valuable, non-invasive supplement to slit-lamp biomicroscopy and histopathology.