Which factors may be associated with the growth in CIN/SCC and its potential progression?

• A. UV exposure, smoking, or HPV virus; benign but may progress to malignant; referral to oculoplastic for management
• B. Bacterial infection
• C. Allergic conjunctivitis
• D. Dry eye disease

Answer: (A)

Growth in CIN/SCC of the conjunctiva and its potential progression are influenced by factors that damage DNA or promote malignant transformation. Ultraviolet exposure repeatedly hits the surface epithelium, causing DNA damage that can lead to mutations and uncontrolled cell growth. Smoking introduces carcinogens that can similarly drive genetic changes in ocular surface cells. Infection with human papillomavirus (HPV) is linked to carcinogenic processes in squamous epithelia, with viral oncoproteins interfering with cellular tumor suppressor pathways and promoting progression from precancerous to invasive disease. CIN is a precancerous lesion that can become squamous cell carcinoma if these processes accumulate.

Other common eye conditions like bacterial infections, allergic conjunctivitis, or dry eye disease can cause irritation or inflammation but are not established drivers of CIN/SCC growth or progression.