A conjunctival cyst is a slow-progressing growth that forms beneath or on the conjunctiva. It manifests as a fluid-filled, thin-walled sac. It is in most cases harmless and asymptomatic.
The conjunctiva is the transparent membrane that covers the sclera. A cyst forms after adhesion of tissues between the conjunctival surfaces (inclusion cyst) or after blockage of ducts (retention cyst). It may be present from birth (congenital) or may be acquired later in life. The latter is known to be more prevalent.
Also Known As
It can broadly be categorized into primary conjunctival cyst and secondary conjunctival cyst.
Causes and Risk Factors
Primary conjunctival cysts develop spontaneously in individuals without an underlying condition. The lesion is in most cases present from birth but may remain hidden in the conjunctival fornix. It then gradually increases with age and may become a nuisance.
Secondary conjunctival cysts develop after an eye injury, surgery or inflammation. Usually, in the case of an operation or injury, the cells adjacent to the scar reorganize and form pockets. The sacs then allow the gathering of extracellular fluids to create the cysts.
Chronic inflammation can be due to allergies, toxic exposure, eye rubbing, injections or conditions such as dry eye syndrome or Steven Johnsons syndrome (SJS). Inflammations cause cysts by inducing tissue adhesions between the palpebral and bulbar conjunctival surfaces. In this case, the fluid is trapped in the formed pockets.
Those at a higher risk of developing cysts are those who have either undergone eye surgery, have experienced trauma or have had eye conditions that caused inflammation.
Signs & Symptoms
The conjunctival cyst is often asymptomatic, but as the lesion grows in size, individuals may present the following signs and symptoms:
- Eye discomfort
- Foreign body sensation
- Excessive tearing or watering
The eye professional will usually perform a slit lamp eye test to check for small conjunctival cysts. The lamp includes a microscope which the professional looks through to view the surface of the eye. The diagnosis should be able to rule out other types of conjunctival lesions.
A biopsy test can also be performed by taking a sample tissue from the cyst. The test will confirm whether the cyst is cancerous or not.
Conjunctival cysts can go away on their own so they do not always require medication. However, treatment can be issued where necessary to relieve the symptoms or drain the fluid. Eye doctors may also perform surgical procedures in some cases.
These include the following:
- Eye drops - They may help with discomfort or dryness. Steroid eye drops may also be prescribed to help prevent further enlargement of the lesion and to reduce inflammation.
- Artificial tears - These are lubricant eye drops. They treat dryness and stabilize the tear film.
Surgical procedures that may be carried out include:
- Needling - It is a procedure that involves using a needle to create multiple holes in the cyst. A topical anesthetic is used to numb the surrounding region. Usually, the fluid leaks over time and the sac flattens in some hours. Doctors prescribe antibiotics before and after this procedure to prevent infection.
- Excision - It involves complete removal of the cyst. The treatment eliminates symptoms such as redness, itching, excessive tearing or watering, abnormal development of the cyst, and drying. Patches are prescribed to regulate bleeding as well as antibiotic ointments to prevent infection.
Individuals may apply a warm compress on the eye with the cysts for 10 to 15 minutes, a few times daily. The remedy assists in promoting drainage and healing. It also helps relieve discomfort and inflammation.
Conjunctival cysts are not known to cause any severity. In some cases, the lesion may even resolve on its own.
However, some patients experience recurrence or enlargement of the lesion. This might occur mainly when the cyst is broken either accidentally when rubbing or on purpose, e.g. during glass rod insertion.
Also, when the lesion increases in size, the tear film may become unstable. The instability can cause complications such as dry eye syndrome.
Recurrence of the cysts can be prevented by careful treatments, particularly for surgical operations. Individuals with cysts should also avoid touching the affected eye to prevent the breaking of the cysts, which may lead to replication.