Elastofibroma oculi.

A 69-year-old woman had a placoid lesion extending from the temporal limbus with a ptyergioid head to involve extensively the temporal epibulbar conjunctiva, the superolateral and inferolateral fornices, and the lateral canthus. It was composed of thickened bundles of collagen, scattered islands of adipose tissue, and abundant refractile linear elastinophilic structures. Electron microscopy confirmed that the elastinophilic structures were mature elastic fibers embedded within markedly thickened bundles of collagen. This lesion resembles elastofibromas that occur in a subscapular location. Elastofibroma oculi is distinguishable from the more common pterygium and pinguecula by the sparing of the immediate subepithelial zone of the conjunctiva, which is preferentially involved by these other lesions, and by failure to exhibit ultrastructurally microfibrillar aggregates and dystrophic elastic fibers. Both the elastic fibers and thickened bundles of collagen in the elastofibroma are presumed to have arisen from activated fibroblasts.