ICD Body System
Date amended:
Statements of Principles
Current RMA Instruments:
Reasonable Hypothesis SOP
41of 2016
Balance of Probabilities SOP
42 of 2016
Changes from previous Instruments:


ICD Coding:
  • ICD-9-CM Codes: 224
  • ICD-10-AM Codes: D31
Brief description

This SOP covers a range of benign neoplasms of the surface and insides of the eye and the lacrimal gland and duct.  A number of other benign tumours close to the eye are not covered.  See the lists below.

Confirming the diagnosis

Biopsy / excision, with histology, is required for definitive diagnosis. However, this may not always be appropriate for some tumour types.  In such cases, a diagnosis based on the clinical findings can be accepted.  Information on the type and site of the tumour will be required to apply the causal factors.

The relevant medical specialist is an ophthalmologist. 

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, optic nerve, orbital bone#
  • Haemangioma (including of choroid or orbit)#
  • Lipoma*
  • 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 will be when the lump or lesion, subsequently diagnosed to be a benign neoplasm of the eye or adnexa, was first noticed.

Clinical worsening

The only worsening factor is for inability to obtain appropriate clinical management.