Background: Ocular surface squamous neoplasia is a spectrum of diseases encompassing from mild dysplasia to invasive squamous cell carcinoma of the ocular surface.Patients and methods: A series of 50 cases with suspected ocular surface squamous neoplasia presenting to Gondar University Hospital Tertiary Eye Care and Training Center, Northwest Ethiopia from January 2015 to June 2016 were enrolled. Clinical parameters were documented through interviewer administered questionnaire and ocular examination. Excisional or incisional biopsy was done on suspected conjunctival lesions and sent for histopathology examination to an experienced pathologist. Statistical Packages for Social Sciences version 21 was used to analyze data.Results: Mean age of the participants was 41.26 years (age range 18-75) and 72% of the cases were males. Majority of the participants were farmers (40%). Human immunodeficiency virus (HIV) was positive in 22% of the participants. Leukoplakic appearance was the commonest (68%) and nasal side of the conjunctiva was the commonest location of the lesions (72%). Feeding vessels were observed in 84% of the participants. Histopathological examination revealed ocular surface squamous neoplasia in 96% of the participants. Among these 36% had carcinoma in situ, 36% had invasive squamous cell carcinoma, 18% had conjunctival/corneal intraepithelial neoplasia and 10% had associated pterygium clinically and on histology as well. Conclusion and recommendations:Almost all the clinically suspected OSSN lesions were actual OSSN in histology. Most of the ocular surface squamous neoplasia cases in the study were non-HIV positive young males and had the lesion on their nasal side of the globe. Despite the age of the patient and status of HIV infection it is good to subject suspected OSSN lesions for histopathological examination. Most of the patients were farmers and the role of other risk factors need to be considered and large-scale studies are recommended in Ethiopia and other African countries in the future.
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