A conjunctival cyst is a harmless, fluid-filled sac. It forms on the conjunctiva, the thin, transparent membrane covering the white part of the eye and lining the inside of the eyelids. Conjunctival cysts are typically thin-walled and contain clear or yellowish fluid.
Causes and Symptoms of Conjunctival Cysts
Conjunctival cysts can arise from various factors. Some are present from birth (congenital cysts). Other cysts, termed inclusion cysts, frequently develop following eye trauma or surgeries such as cataract or strabismus correction. These form when conjunctival tissue folds over itself, creating a fluid-filled pocket.
Retention cysts form when tiny ducts within the conjunctiva become blocked due to chronic inflammation, environmental irritants like dust or smoke, or allergens. The cyst typically appears as a visible, clear, or yellowish bump on the white part of the eye. Many small cysts cause no symptoms and are discovered during routine eye examinations.
When symptoms occur, they can include a foreign body sensation, irritation, and redness. Excessive tearing can also occur. Larger cysts might cause discomfort when blinking or moving the eye, and in rare instances, they can affect vision if they obstruct the visual axis.
Diagnosis by an Eye Doctor
Diagnosing a conjunctival cyst typically involves a comprehensive eye examination performed by an optometrist or ophthalmologist. The eye care professional will begin by taking a detailed medical history, inquiring about any previous eye conditions, injuries, or surgeries. During the physical examination, the doctor will visually inspect the eye to assess the cyst’s appearance, size, and exact location on the conjunctiva.
A primary diagnostic tool used is the slit lamp microscope. This instrument provides a magnified, three-dimensional view of the eye’s structures, illuminated by a bright, focused beam of light. The slit lamp allows the doctor to closely examine the cyst’s characteristics, such as its wall thickness and internal contents, and to measure its dimensions accurately. The examination also helps to distinguish a conjunctival cyst from other eye conditions that might appear similar, like pingueculae or pterygia, ensuring an accurate diagnosis.
Treatment Approaches
Small, asymptomatic conjunctival cysts generally do not require active treatment. An eye care professional may recommend a watchful waiting approach, where the cyst is simply monitored during regular eye exams to observe for any changes in size or the development of symptoms. Some small cysts may even resolve on their own over time without any intervention.
For cysts that cause irritation or discomfort, non-invasive options are often considered first. Lubricating eye drops can be used to alleviate dryness and reduce friction caused by the cyst rubbing against the eyelid. Corticosteroid eye drops may also be prescribed to help reduce any inflammation associated with the cyst, potentially preventing it from growing larger. Applying warm compresses to the affected eye can sometimes help ease discomfort and may encourage natural drainage for certain types of cysts.
If a conjunctival cyst becomes persistently irritating, grows significantly, is cosmetically bothersome, or affects vision, more direct interventions may be considered. A minimally invasive procedure called aspiration can be performed, where a fine needle is used to puncture the cyst and drain the fluid. This procedure offers temporary relief, though there is a possibility of the cyst recurring. Surgical excision, which involves the complete removal of the cyst, is typically reserved for larger, recurrent, or highly symptomatic cysts. This outpatient procedure, usually performed under local anesthesia, is considered a definitive solution; the choice of treatment depends on the cyst’s specific characteristics, its impact on the individual, and the severity of symptoms.