# Benign Lymphoid Hyperplasia Presenting as Bilateral Scleral Nodules

## TL;DR

A young man had benign eye nodules caused by an immune response to allergens, which was confirmed through biopsy.

## Contribution

This case report highlights a rare presentation of benign lymphoid hyperplasia in the eye due to allergic reactions.

## Key findings

- Bilateral scleral nodules were found to be benign lymphoid tissue through biopsy.
- Immunohistochemistry showed a polyclonal mix of T and B cells, indicating a reactive immune process.
- Chronic allergen exposure may trigger immune responses leading to transient lymphoid hyperplasia.

## Abstract

Purpose. To report a case of transient lymphoid hyperplasia presenting as bilateral nodular scleral mass in a young male patient. Design. Observational case report. Methods. Chart review. Causes of scleritis were considered and excluded based on detailed history, physical examination, and laboratory investigations. Results. Excisional biopsy of scleral lesions indicated lymphoid tissue. Immunohistochemical studies revealed a polyclonal population of T and B cells consistent with a benign reactive process. Conclusions. Chronic exposure of the ocular adnexa to many allergens and irritants may lead to activation of the inflammatory cascade. In severely allergic patients activation may be exponential and elicit an immune-mediated response resulting in a transient lymphoid reactive process.