What is the recommended management for CIN/SCC?

• A. Refer to ocular oncology for management or removal, with biopsy ± cryotherapy
• B. Immediate enucleation
• C. Topical antibiotics
• D. Observation only

Answer: (A)

Management of conjunctival intraepithelial neoplasia and squamous cell carcinoma starts with histologic confirmation and proper assessment of extent, so a biopsy is essential. Because these lesions are malignant potential, they should be managed by an ocular oncology team to determine the best course, which often means removal or globe-sparing treatment with clear margins and adjunctive therapy. Cryotherapy to the surgical margins is a common adjunct after excision, and topical chemotherapy or other targeted treatments may be added based on histology and extent. Enucleation or exenteration is reserved for advanced cases with extensive invasion, not as a routine first step. Antibiotics alone or observation do not treat the neoplasm.