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Conjunctival cyst - causes, symptoms and treatment

Conjunctival cyst - causes, symptoms and treatment


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Eye diseases are often associated with a high risk of vision, because sooner or later they will attack eye structures that are essential for vision if not treated. This applies in particular to eye infections and degenerative eye diseases such as retinitis pigmentosa. The so-called conjunctival cyst is much less dangerous here. Although it can also be the result of inflammation in the eye area, it can usually be treated well and, thanks to its locally limited character, does not spread to other structures of the eye.

Nonetheless, a steadily growing conjunctival cyst can be extremely uncomfortable and can sometimes indicate serious health problems on the eye. You can find details on the causes of a conjunctival cyst and important information on therapy in our article on the subject.

In the following, we have summarized the most important points for you on the subject of “conjunctival cyst”:

  • definition: A retention cyst is a small, transparent vesicle under or on the conjunctiva, which is filled with fluid. Due to its small size, it is barely visible to the naked eye.
  • causes: Eye impurities (skin flakes, dust etc.), injuries, inflammatory diseases in the area of ​​the eyes, genetic cyst diseases, regular use of eye drops, conjunctival surgery (for example in the case of strabismus).
  • Symptoms: Pimple-like swelling on or under the conjunctiva and foreign body sensation in the eye, depending on the cause, itchy, burning, red and watery eyes, dry eyes, visual problems, eye swelling and pain, purulent discharge and red eyes can occur.
  • therapy: Depending on the cause, eye rinsing, eye drops with antibiotics, medicinal plants such as euphrasia or surgical removal may be considered for the treatment of the conjunctival cyst. The small vesicles often heal spontaneously. Supportive care should be taken to protect the eyes.
  • Definition - conjunctival cyst

    The human conjunctiva (tunica conjunctiva) is a thin, transparent layer of mucous membrane in the eye socket that lines the inside of the eyelid (blepharon or palpebra). It envelops and forms the so-called conjunctival sac (Saccus conjunctivae) within the eye socket, into which the tear glands open.

    The main function of the conjunctiva is therefore to distribute the tear fluid evenly over the cornea. For this purpose, the mucosal epithelium of the conjunctiva wipes over the cornea like a damp cloth with every blink of the eye. Smaller dirt particles are also removed by this wiping movement and the cornea is thus cleaned regularly.

    A conjunctival cyst now describes a pimple-like elevation in the conjunctival tissue that belongs to the benign and therefore harmless tumors. The medical term “cyst” is derived from the Greek word kıstis for "bubble". Accordingly, cysts are basically void-like cavities in the tissue, whereby the following variants are differentiated depending on the content of the cyst:

    • Simple cyst - filled with tissue fluid,
    • Atheroma - filled with sebum,
    • Empyema - filled with blood or pus,
    • Lung cyst - filled with air,
    • Kidney cyst - filled with urine secretion,
    • Parasitic cyst - filled with parasites or their eggs,
    • Pustule - filled with pus and / or sebum
    • and mucous cyst / mucoid cyst - filled with mucus.

    The content of air or secretions in a real cyst is also always surrounded by an epithelial cuticle that lines the inside of the cyst. So it forms a closed sac within the cyst bladder. If this epithelial lining is missing or only a connective tissue cyst wall is present, medicine speaks of a "pseudocyst".

    Cysts can occur either sporadically or in clusters and divided into several cyst chambers. In this context, medicine speaks of “polycysts” whenever a large number of cysts occur simultaneously.

    The conjunctival cyst is usually a real cyst filled with clear tissue or tear fluid. As the name suggests, it arises in the conjunctival tissue and usually appears there as a transparent vesicle, which due to its small size is difficult to see with the naked eye.

    Even the smallest conjunctival cysts are felt relatively quickly by those affected, as they cause a clear feeling of a foreign body when blinking, as well as when moving the eye. Numerous cysts in the area of ​​the conjunctiva are accompanied by corresponding pre-existing diseases of the eye, such as conjunctivitis, which can lead to other accompanying symptoms such as burning, painful or oozing eyes.

    Eye contamination as the main cause

    Most often, conjunctiva cysts are caused by dirt particles and foreign body residues such as skin flakes or dust particles that collect under the eyelid. Frequent rubbing of the eyes, but also due to the mere repetition rate of the daily blinking, sooner or later the residues or particles are enclosed in the mucosal epithelium of the conjunctiva. The resulting cavity in the mucosal tissue is then increasingly filled with tissue fluid, which ultimately triggers the development of the conjunctival cyst.

    Important: In many cases, poor hygiene plays a special role in conjunctival cysts due to contamination. This does not primarily mean missed eye cleansing, but rather rubbing the eyes with unwashed fingers. Not only does this behavior rub excessive dirt particles into the eye, it can also contribute to serious eye infections by rubbing germs into the eyes, which can also be used to trigger the cyst. For more information, please refer to our section on causes of inflammation for cysts in the area of ​​the conjunctiva.

    Occasionally conjunctival cysts also arise from clogged gland ducts. Again, impurities can be held responsible for this, which hinder the emptying of the affected glands. The lacrimal glands of the conjunctiva are significantly affected. One speaks here also of the so-called tear gland cyst (Dakryops). Although it is just as harmless as the common conjunctival cyst, it can cause dry eyes by closing the tear ducts, because the tear fluid can no longer flow freely due to constipation.

    Medically, a cyst that is caused by a corresponding drainage disorder is also referred to as a “retention cyst”. It occurs relatively frequently in the area of ​​the conjunctiva, which is why the term is often incorrectly used as a generalized term for conjunctival cysts. However, by definition the retention cyst only describes cysts that have arisen from an existing disorder in the flow of secretions. In this regard, complaints such as glandular blockages or glandular stenosis due to narrowed gland ducts come into question almost exclusively.

    Conjunctival cyst due to eye injuries

    Eye injuries are also conceivable as the cause of cysts in the area of ​​the conjunctiva. Even the slightest micro-injury can set the cyst in motion. Small tissue tears cause impurities and sometimes inflammatory agents to penetrate the conjunctiva, so that corresponding cavities in the conjunctival tissue are not long in coming.

    Injuries to the conjunctiva often arise from foreign bodies already in the eye, which represent a persistent irritation for the mucous membrane of the eye. Friction can then trigger corresponding micro-injuries. For example, eye injuries caused by sharp-edged contact lenses or microscopic fragments that find their way into the eye are typical.

    Eyes that are particularly dry, for example due to insufficient moistening by tear fluid or extremely dry air conditions (especially in summer and due to heating air in winter) tend to increase the risk of injury. Last but not least, tangible eye trauma, for example due to blows to the eye and inflammation-related injuries to the conjunctiva, are also conceivable as the cause of the cyst formation.

    Cyst of the conjunctiva due to eye inflammation

    The cause of the possible eye diseases is particularly large with conjunctival cysts. For example, germ-prone contamination of the eye often causes infections of the conjunctiva, which in turn lead to inflammatory diseases such as conjunctivitis (conjunctivitis). In this context, conjunctival cysts are no longer completely harmless, but indicate serious illnesses in the eye. Because especially if it is a bacterial or viral conjunctivitis, non-treatment threatens permanent damage to the conjunctiva, which can permanently impair vision.

    Typical accompanying symptoms of the conjunctival cyst in conjunctivitis are

    • a pronounced foreign body sensation in the eye,
    • itchy eyes,
    • increased lacrimation,
    • Sensitivity to light
    • and red eyes.

    Another inflammatory disease in the area of ​​the eyes that can cause a conjunctivitis cyst as a secondary disease is scleritis. It is named after the dermis, also known as “sclera”, which describes the white area of ​​the eyes and is also covered by the conjunctiva in the transition area to the cornea.

    In the absence of treatment, inflammation in this area of ​​the eye can pass to the conjunctiva and then lead to fluid accumulation in the conjunctival tissue via inflammation secretions, which consequently cause a cyst. As with conjunctivitis, with scleritis, accompanying symptoms such as itchy eyes, burning eyes, or reddening of the eyes can occur as the cause of the cyst.

    In contrast to conjunctivitis, there are other triggers for the dermatitis apart from infectious agents. These include

    • Gout,
    • Herpes zoster,
    • Rheumatism,
    • Sarcoidosis,
    • syphilis
    • and tuberculosis.

    Conjunctival cysts with an existing allergy

    Above all, conjunctivitis is also favored by allergies, which trigger inflammatory processes on the eye due to trigger factors. In addition, the mere inflammation itself can provoke a cyst in the area of ​​the conjunctiva.

    This applies in particular to allergy variants such as pollen allergy, which is known to irritate the eyes in a very targeted manner. The allergic reactions of the body that occur here primarily affect structures within the conjunctiva and lead, among other things, to tissue swelling and an increased flow of tears. If excess tear fluid penetrates into swellings in the eye mucosa, cyst formation is often not long in coming. In addition, there are inflammations triggered by the allergy, which promote inflammation of the conjunctiva cysts via inflammatory secretions.

    Genetic predisposition

    There are a number of inherited disorders associated with chronic cystic disorders such as:

    • Ovarian cysts,
    • Brain cysts,
    • Liver cysts
    • and kidney cysts.

    and others can go hand in hand. Cysts in the conjunctival tissue can also be triggered by congenital tissue deviations. Genetic defects in the area of ​​hormone control or gene mutations in structural proteins that help to shape the tissue are often responsible for such inherited cyst diseases.

    Other causes and risk factors

    If you regularly use eye drops, you can increase the risk of cyst formation in the eye. The reason for this is the constant supply of extraneous substances that are not infrequently responsible for drainage disorders and can thus lead to a retention cyst. Conjunctival surgery can also result in the formation of a conjunctiva cyst. Examples of this are surgical interventions to remove a pterygium (“wing skin”) or to reduce or remedy strabismus (squint).

    Other risk factors are special work environments that particularly support eye contamination. A good example is working in mines or factories with high pollution levels. Activities that are strenuous for the eyes, such as office work, can promote cyst formation due to dry eyes and irritated eyes. Last but not least, leisure activities with a particular risk of pollution and inflammation for the eyes should be mentioned, such as cycling without protective goggles, diving at great depth or playing sports in a dusty environment.

    Conjunctival cyst - symptoms

    The cardinal symptom of the conjunctival cyst is the pimple-like swelling in the inner area of ​​the eyelid. This usually appears clearly transparent, in rare cases also milky cloudy, provided the transparent sacking of the cyst epithelium is filled with unclear secretions such as pus.

    The elevation of the cyst is usually associated with an uncomfortable feeling of a foreign body in the eye, which is particularly noticeable in eye movements such as blinking or looking left, right, up or down. In this context it should also be mentioned that the swelling of the cyst can scratch due to movement stimuli or can increase due to friction, which intensifies the feeling of foreign bodies. This is especially true for closely spaced polycysts. For this reason, it is advisable to move the eye as little as possible if there is a conjunctival cyst.

    Depending on the underlying cause, other accompanying symptoms may occur. With inflammation of the eye - as with existing allergies - as mentioned above, itchy, burning, watery or red eyes are possible. A purulent discharge is also conceivable if the inflammation is due to an infection and is already very advanced. With a retention cyst, there is still a risk that the eyes will appear particularly dry due to persistent drainage problems in the lacrimal glands.

    In the case of a conjunctival cyst, the risk of impaired vision is essentially due to injuries to the eye. However, this does not mean that other causes are generally not able to cause visual problems. Again, inflammation of the eyes should be mentioned, which can pose a risk to eyesight. This is especially true if the inflammation has remained untreated for a very long time and has caused serious damage to the structures of the eye.

    For a better overview of possible symptoms of a conjunctival cyst, here are all possible side effects in full:

    • Burning eyes,
    • Eye pain,
    • purulent discharge,
    • Foreign body sensation in the eye (especially when moving),
    • red eyes,
    • swollen eyes or eyelids,
    • itchy eyes,
    • Visual problems (e.g. perception of floating fog in front of the eye),
    • watery eyes.
    • and dry eyes

    Diagnosis

    Simple conjunctival cysts, such as those caused by one-time contamination, usually do not need to be treated separately and mostly heal on their own. However, if the symptoms persist for a long time or worsen over time, a medical inspection is strongly recommended.

    The eye doctor can determine the cyst elevation as part of an eye diagnosis. To do this, he uses a slit lamp to illuminate the eye in a targeted manner. In addition, certain symptoms such as reddening of the eyes or swelling of the eyelids provide further evidence of the presence of a cyst.

    In some cases, ophthalmologists measure the intraocular pressure. The pressure that the aqueous humor exerts on the eye is measured. For this purpose, a thin metal plate is positioned on the locally anesthetic eyeball with the help of a special measuring apparatus and the resistance is measured with a gentle pressure supply.

    In this regard, the normal intraocular pressure is between ten and 21 millimeters of mercury (mmHg). Pressure conditions above the normal level can also indicate an abnormal fluid accumulation, for example due to drainage disorders in the tear fluid, and thus indicate a retention cyst or the stasis of inflammatory secretions. A negative pressure in the eye in turn suggests dry eyes.

    Danger: Persistent overpressure in the eye can cause irreparable damage to the optic nerve. If a conjunctival cyst causes extremely dry eyes and is not treated in time, glaucoma, also known as glaucoma, is at risk.

    Therapy for conjunctival cyst

    In many cases, conjunctiva cysts experience spontaneous healing and therefore do not require special treatment. Nevertheless, treatment is never completely ruled out and must be followed very carefully, especially in the presence of inflammation and injury to the eye, in order to prevent permanent damage to the eye. In addition, with uncomplicated conjunctival cysts, there are some private measures that sufferers can take to accelerate healing. Please refer to the overview below for details.

    Measures to protect the eye

    In order to avoid further eye irritation when there is a conjunctival cyst, it is important to consciously protect the eyes. For this purpose, avoid too frequent eye movements and temporarily suspend strenuous activities for the eyes until they have completely healed. This includes time-consuming work in front of the screen as well as long reading. Rapid eye reactions, such as those required when driving a car, eye strain caused by glaring light, dry indoor air or watching television should also be avoided.

    With existing eye infections, it is also important to protect the eye from drafts and cold, moist air. The inflammatory process could otherwise worsen. Activities such as swimming or going to the sauna should also be avoided in order not to expose the eye to a damp or wet surrounding environment. Instead, patients with conjunctival cyst should keep their eyes closed for a longer period of time and take regular breaks in vision so that the strained eye can recover.

    Eye rinsing and moisturizing

    If there are foreign or dirt particles in the eye, an ophthalmologist may clean them with a special eye wash. It is also possible to flush clogged tear ducts or to moisturize the eye with special solutions in extreme drought.

    The latter is usually best achieved by using suitable eye drops, whereby great care must be taken here to choose preparations that will not dry out the eye in the long term. A side effect that is unfortunately present in numerous eye drops and must therefore be avoided by using only drops that have been specifically selected by the ophthalmologist. So please refrain from indiscriminately buying and using eye drops yourself.

    Medicinal measures

    There are some herbs that are particularly recommended for eye problems such as the conjunctival cyst. This particularly includes Euphrasia, the eyebright. His name is no coincidence, since it has proven itself over the centuries in particular in the treatment of eye diseases. Eyebright can also help with conjunctival cysts. It can be used in the form of compresses, ointments or special eye drops, for example. When used as a tea, the medicinal herb can support the healing powers of the eye internally. Appropriate preparations are available in every pharmacy.

    Disinfectant herbs such as sage, chamomile or black tea are recommended as the cause of the conjunctivitis if eye inflammation is present. They can also be used as compresses.

    Caution: We would like to expressly point out that infection-related and oozing inflammation should under no circumstances be provided with additional moisture. Herbal ointments prescribed by the doctor are definitely preferable here. They can be applied to the eyelid from the outside and thus help with recovery.

    In summary, the following herbs are recommended for conjunctivitis:

    • Eyebright (Euphrasia),
    • Oak bark,
    • Fennel,
    • Chamomile,
    • Marigold,
    • sage
    • and black tea.

    Nutritional measures

    Proper nutrition is also important to support the eye's ability to regenerate. Black and red berries like

    • Apple (aronia),
    • Cranberry,
    • Blueberries,
    • Blackberries,
    • Rosehips,
    • Blueberries,
    • Cranberries
    • or black currants

    For example, they contain important antioxidants that trap free radicals and help to remove harmful substances from the eye. Foods that are high in vitamin C and vitamin E also have a similar effect. In addition to berry fruits, nuts and vegetable oils, this mainly includes vegetables such as

    • Broccoli,
    • Kohlrabi,
    • Paprika,
    • Brussels sprouts,
    • Salad,
    • Spinach,
    • tomatoes
    • and savoy cabbage.

    Speaking of vitamins - there is a vitamin that is specifically called an eye vitamin because it is essential for maintaining eye health. We are talking about vitamin A, which is also known as ß-carotene, because it forms the orange-red dye in carrots, which are particularly rich in the vitamin. But other red-orange vegetables and fruits such as peppers, tomatoes, mango and apricots also have this healthy coloring. Fish and animal liver also contain large amounts of vitamin A and should therefore be consumed more frequently if eye problems exist.

    Medication

    Eye inflammation and eye injuries as the cause of the conjunctival cyst naturally require special therapy. Otherwise the cyst will not heal as a complaint. The first choice here are eye drops with antibiotic and anti-inflammatory agents as well as corticosteroids. Regarding the latter, however, it should be mentioned that they sometimes have serious side effects and should therefore only be used in extreme emergencies.

    Operative measures

    If a conjunctival cyst is particularly large and uncomfortable or occurs again and again, surgical intervention can often not be avoided. The simplest variant of the operation here is to prick the cyst. By opening the cyst inclusion, the secretions accumulated in it can drain away more easily and healing can proceed faster.

    Attention: At this point, we explicitly warn against "doctoring" about the cyst and fiddling with it indiscriminately! This can not only lead to secondary inflammation due to insufficiently sterilized “surgical material”. Likewise, the eyesight is severely endangered by such self-tests and stings in sensitive tissue layers can lead to permanent damage to the eye. Therefore, only have a conjunctival cyst pricked by an experienced ophthalmologist!

    The second option for the surgical removal of a conjunctival cyst is laser surgery. Stubborn cysts can not only be obliterated by the hot laser beam, but also disinfected at the same time. As an alternative, there is also the option of causing the cyst to become obliterated by supplying electricity, known as cauterization. For this purpose, electrically heated wire loops are used instead of a laser. Both the laser and the cauterization are performed under local anesthetic of the eye. (ma)

    Author and source information

    This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

    Swell:

    • Lang, Gerhard K .: Ophthalmology, Thieme, 2019
    • Pleyer, Uwe: Inflammatory Eye Diseases, Springer, 2014
    • Mallikarjun Salagar, Kavita; Pujari, M. R .; Murthy, Chethan N .: A Rare Case Report of Conjunctival Cyst, in: Journal of Clinical and Diagnostic Research, 9 (11), September 2015, PubMed
    • Thatte, Shreya; Jain, Jagriti; Kinger, Mallika et al .: Clinical study of histologically proven conjunctival cysts, in: Saudi Journal of Ophthalmology, 29 (2): 109-115, April-June 2015, PMC
    • Min, Xiaoshan; Jiang, Hui; Shi: Descriptive Study of Conjunctival Cysts: A Rare Complication after Strabismus Surgery, in: Journal of Ophthalmology, Volume 2018, Article ID 1076818, 2018, Journal of Ophthalmology
    • Han, Sang Beom; Yang, Hee Kyung; Hyon, Joon Young: Removal of conjunctival cyst using argon laser photoablation, in: Canadian Journal of Ophthalmology (CJO), 47 (3): e6 – e8, June 2012, CJO
    • Paduch, Roman; Woźniak, Anna; Niedziela, Piotr; Rejdak, Robert: Assessment of Eyebright (Euphrasia Officinalis L.) Extract Activity in Relation to Human Corneal Cells Using In Vitro Tests, in: Balkan Medical Journal, 31 (1): 29–36, March 2014, PMC

    ICD-Codes for this illness: H11.4ICD-Codes are internationally valid encodings for medical diagnoses. You can find yourself e.g. in doctor's letters or on disability certificates.


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