Dr. Orwa Nasser MD MPH - Conjunctival Cyst

Conjunctival Cyst

A conjunctival cyst is a benign, fluid-filled sac that forms on the conjunctiva, the thin membrane covering the white part of the eye and lining the inside of the eyelids. These cysts are usually harmless and may go unnoticed when small. They may develop spontaneously, be present at birth, or occur later due to irritation, inflammation, or trauma. Most conjunctival cysts do not threaten vision but may cause discomfort depending on size and location.

Symptoms:

·    Many conjunctival cysts cause no symptoms.

·    A visible bump or blister-like sac on the eye surface.

·    Foreign-body sensation.

·    Mild irritation or discomfort when blinking.

·    Redness around the cyst.

·    Increased tearing.

·    Difficulty closing the eye comfortably if the cyst is large.

·    Rarely blurred or double vision if eye movement is affected.

Causes:

·    Conjunctival cysts form when fluid becomes trapped within the conjunctival tissue.

·    Inclusion cysts occur when conjunctival tissue folds over itself and creates a fluid-filled pocket.

·    Retention cysts develop when small ducts become blocked and fluid accumulates.

·    They may be congenital or acquired later in life.

·    Acquired cysts can result from trauma, eye surgery, chronic inflammation, allergies, dry eye, or repeated irritation.

Diagnosis and Tests:

·    Diagnosis is usually made during a comprehensive eye examination.

·    Slit-lamp examination allows detailed visualization of the cyst.

·    Visual acuity testing ensures that vision is not affected.

·    In rare cases, imaging or biopsy may be performed to confirm the diagnosis.

·    Most cysts are diagnosed clinically without invasive testing.

Management and Treatment:

·    Medical Procedures: in advanced cases of multiple cysts, large cysts, or cometically bothering cysts surgical removal is advised.

o   Surgical excision removes the cyst completely and lowers recurrence risk.

o   Procedures are typically performed under local anesthesia with short recovery time.

·    Observation: Small and asymptomatic cysts often require no treatment and can be monitored over time.

·    Supportive Care: Artificial tears may reduce irritation and dryness.

·    Anti-inflammatory drops may be prescribed if inflammation is present.

Prognosis:

·    The prognosis for conjunctival cysts is excellent.

·     Most remain stable or resolve without complications.

·    Removal procedures generally result in full recovery.

·    Recurrence may occur, especially if underlying irritation persists.

Prevention:

·    There is no guaranteed method to prevent conjunctival cysts.

·    Avoiding chronic eye irritation may reduce risk.

·    Protective eyewear helps prevent trauma-related cyst formation.

·    Managing dry eye and allergic conditions may lower recurrence risk.

When Should I See My Healthcare Provider? Seek evaluation if you notice a new bump on your eye or experience persistent irritation.

When Should I Go to the Emergency Room? Go immediately if you develop sudden vision changes, severe pain, or intense redness.

What Questions Should I Ask My Healthcare Provider?

    ·    Is this a conjunctival cyst or another type of growth?

    ·    Will it resolve without treatment?

    ·    Do I need aspiration or excision?

    ·    What is the chance of recurrence?

    ·    How often should I follow up?

Key Takeaways:

    ·    Conjunctival cysts are benign fluid-filled sacs on the eye surface.

    ·    Many cause no symptoms and require only monitoring.

    ·    Larger cysts may cause irritation or foreign-body sensation.

    ·    Treatment options include observation, aspiration, or excision.

    ·    Prognosis is excellent with proper care.