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Includes Expert Content
brown patch near the lacrimal punctum part of eye?
Anon_41642 posted:
I am 30, never smoked or any tobacco consumption. I have a 20/20 vision. Three days ago, I noticed a brown line near my lacrimal punctum. The brown line is between the superior and inferior lacrimal canal
1. What could it mean?
2. Should fix an appointment with an optometrist? Issue is it takes 3 weeks to get one since they are swamped.
Alan M Kozarsky, MD responded:
I will assume that you are talking about brown pigmentation on the white conjunctiva of your eye but the concept is similar if the pigment is on your eyelid where the lacrimal punctae are located.

First question is whether pigmentation is truly new or whether you have just noticed it? Benign areas of pigmentation are common in this area and are characterized by darkening during adolescence, being relatively small and flat with uniform color. Melanomas can occur in this location but nevi (freckles) are much more common. .

Best idea is to have an ophthalmologist evaluate and photograph in regard to any future growth. If the ophthalmologist has any suspicion a biopsy can easily be performed.
m_j_95 replied to Alan M Kozarsky, MD's response:
Thanks Alan,

It is somewhat like but is in my right eye, instead of spots it is like a brown line between the superior and inferior lacrimal canal.

Yes, it is truly new. It did not exist before two months. I am an Asian and estimate freckles are common for Asians, but wonder why did this show up suddenly?

Can I do anything to reduce/eliminate it?

Thank you again.
Alan M Kozarsky, MD replied to m_j_95's response:
No, there is generally no treatment recommended to reduce or eliminate the pigmentation

It is important to allow an ophthalmologist to carefully examine the pigmented area and photograph/biopsy if needed.

These areas are generally benign and need only be observed.
m_j_95 replied to Alan M Kozarsky, MD's response:
Thanks Allan:

1. What could have caused it to appear suddenly?

2. Can I do something to prevent it from spreading? My sun exposure is less than 30mins/day. I live in North Florida

3. An optometrist told me that it cannot be photographed because their cameras cannot capture something which is so small. He told me that I need to watch it and visit them again if it grows/changes shape. Do you feel I should visit an ophthalmologist? I cannot visit one until I am referred to according to my insurance coverage.

I appreciate your time and assistance.
Alan M Kozarsky, MD replied to m_j_95's response:
1. Can't guess on cause without a definite diagnosis.

2. Can't advise on precautions without a diagnosis.

3. Tell your "gatekeeper" that you have a concern about this being a surface eye tumor and that the optometrist could not give you definitive information or document the finding. It would be an unusual primary care doctor who would prevent you from seeing an ophthalmologist in this situation.
m_j_95 replied to Alan M Kozarsky, MD's response:
Thanks Allan:

1. What I wanted to know is this typical based on your experience for my age group, ethnicity like you mentioned earlier "Benign areas of pigmentation are common in this area and are characterized by darkening during adolescence, being relatively small and flat with uniform color" I realize each individual is different, there could be N reasons for this and

3. My optometrist told me that it is normal because of my ethnicity and if it changes shape, color I can visit them again. According to the insurance representative, I need to get the optometrist's referral to visit an ophthalmologist just like I need a dentist's referral to visit a oral surgeon. I did not think it would be that way but an optometrist is a specialist according to my insurance and I am charged a co-pay like I am visiting a specialist.

I appreciate your time and assistance.
m_j_95 replied to m_j_95's response:
Also, I wanted to add the optometrist felt just like was typical for people with dark colored skin, my patch was also normal for me as I am a Asian.

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