Conjunctival melanosis associated with occupational exposure to airborne organic compounds: a case report and review of literature.

Conjunctival pigmentation is a multifactorial condition that may be associated with occupational exposure to airborne organic compounds, but clinical reports of such cases remain limited. A 40-year-old Han Chinese male presented with scattered black deposits on the conjunctiva and lacrimal caruncle after prolonged occupational exposure to airborne organic compounds (phenylenediamine) without personal protective equipment. He was advised to avoid further exposure. At the 3-month follow-up, the pigmentation in both eyes had partially improved. The patient requested surgical treatment for cosmetic concerns in one eye; selective excision of the pigmented conjunctiva combined with amniotic membrane transplantation was performed, achieving satisfactory outcomes. The contralateral eye was kept under observation, and after 1 year of continued avoidance of exposure, the pigmentation in the unoperated eye had further decreased substantially. Histopathology of the excised tissue revealed increased melanocytes within the conjunctival epithelial basal layer without atypia, confirming a benign reactive process and excluding malignancy. Occupationally acquired conjunctival pigmentation may partially and progressively resolve after removal of the causative agent. For patients with persistent lesions or cosmetic requests, partial conjunctival resection combined with amniotic membrane transplantation can be an effective treatment option.