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What is ocular surface squamous-cell neoplasia (OSSN)?
What is ocular surface squamous-cell neoplasia (OSSN)?
Ocular surface squamous-0ell neoplasia (OSSN) is a type of skin cancer that affects the surface of the eye, usually involving the conjunctiva (the clear skin over the white of the eye) and sometimes the cornea.
It often appears as a slow-growing, raised, fleshy or white lesion on the eye and is more common in people with long-term sun (UV) exposure, fair skin, or weakened immune systems.
When detected early, OSCC is highly treatable, most commonly with surgical removal and sometimes additional treatments such as topical chemotherapy eye drops to reduce the risk of recurrence.
Approximately 3 - 9% of pterygia have dysplastic or cancerous changes.Â
What are the risk factors for OSSN?
What are the risk factors for OSSN?
Ocular surface squamous neoplasia (OSSN) has several well-recognised risk factors, most of which relate to UV exposure and immune status:
Chronic ultraviolet (UV) light exposure, especially in sunny climates
Older age, typically over 50 years
Fair skin and light-coloured eyes
Male sex
Immunosuppression, including HIV infection, organ transplant, or long-term steroid use
Human papillomavirus (HPV) infection
Smoking
Exposure to environmental irritants, such as dust or chemicals
People living in high-UV regions (such as New Zealand and Australia) are at higher risk, making sun protection and early detection particularly important.
What is the prognosis of OSSN?
What is the prognosis of OSSN?
The prognosis of ocular surface squamous neoplasia (OSSN) is generally very good, especially when it is detected and treated early.
Most cases are successfully controlled with surgery and/or topical treatments, with high cure rates and preservation of vision. Recurrence can occur, particularly in more aggressive or advanced cases, but this is usually manageable with close follow-up and additional treatment if needed.
Spread beyond the eye is rare, and long-term outcomes are excellent when patients are monitored regularly and protect their eyes from further UV exposure.
What is the treatment of OSSN?
What is the treatment of OSSN?
Common treatments include:
Surgical excision of the lesion, often with special techniques to reduce recurrence
Topical chemotherapy eye drops (such as interferon, mitomycin C, or 5-fluorouracil) to treat residual disease or avoid surgery in selected cases
Cryotherapy applied to the edges of the lesion during surgery
With appropriate treatment and regular follow-up, most patients achieve good control of the disease with excellent visual outcomes.
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