Benign Neoplasm of the Eye and Adnexa B049

Current RMA Instruments:

Changes from previous Instruments:

ICD Coding:

• ICD-10-AM Codes: D31.0, D31.1, D31.2, D31.3, D31.4, D31.5, D31.6, D31.9

Brief description

This SOP covers a range of benign neoplasms affecting both the surface and internal structures of the eye, as well as the lacrimal gland and duct.  Certain types of benign tumours near the eye are excluded- refer to the lists below for details.

Benign ocular neoplasms are defined as non-malignant proliferations of cells within the eye or its adnexal structures, classified by site as follows: conjunctiva, cornea, retina, choroid, ciliary body, lacrimal gland, lacrimal duct and orbit.  

The adnexa of the eye refer to the accessory structures that support ocular function. These include the lacrimal gland, lacrimal duct, conjunctival sac and orbit, excluding the eyeball itself and the optic nerve. 

Confirming the diagnosis

Histological confirmation through biopsy or excision is the gold standard for definitive diagnosis. However, for certain tumour types, biopsy may not be appropriate or feasible. In such cases, a diagnosis based on clinical findings may be considered acceptable. Accurate information regarding the tumour type and anatomical site is essential for applying the relevant causal factors. 

Diagnostic confirmation is best guided by specialist ophthalmologists. 

Diagnoses covered by SOP

• Benign neoplasms of conjunctiva, cornea, retina, choroid, ciliary body, lacrimal gland, lacrimal duct, orbit (excluding bone)
• Adenoma of the retinal pigment epithelium
• Choroidal osteoma
• Epibulbar dermoid
• Keratoacanthoma of conjunctiva
• Neurofibroma (single) of the eye
• Melanocytoma (benign) of iris
• Papilloma of conjunctiva
• Schwannoma (neurilemmoma) of the eye

Conditions not covered by SOP

• Benign neoplasm of eyelids
• Benign neoplasm of the optic nerve
• Benign neoplasm of the orbital bone #
• Haemangioma (including of choroid or orbit) #
• Lipoma of the eye *
• Lymphangioma (including of the orbit) #
• Malignant neoplasm of eye *
• Melanocytic naevi (including of choroid) #
• Melanocytoma of optic nerve #
• Meningioma of optic nerve sheath * - cerebral meningioma
• Neurofibromatosis #
• Ocular surface squamous dysplasia #
• Pinguecula *
• Pterygium *
• Retinal vasoproliferative tumour #
• von Hippel angioma #

* another SOP applies

^# non-SOP condition

Clinical onset

Clinical onset is defined as the time when the lump or lesion, or other relevant symptoms- later confirmed to be consistent with a benign neoplasm of the eye or its adnexa- was first observed. 

Clinical worsening

The only clinical worsening factor involves the inability to obtain appropriate clinical management.