Nevi of the conjunctiva are similar in pathology and behavior to those of the skin. They may be acquired or congenital, and they may be benign or malignant.

Pigmentation in congenital nevi may not be noted until adolescence.

Nevi may be intraepithelial, subepithelial, or compound. Spindle cell and blue nevi are less common. In puberty, intraepithelial nevi may mature and become more subepithelial, leading to a transition from flat to raised and a recognition of change from the patient.

Nevi are sometimes confused with benign acquired conjunctival melanosis or primary acquired melanosis, which is discussed in the section on conjunctival melanosis.