Conjunctival Cyst

What is a conjunctival cyst?

A conjunctival cyst is a benign (noncancerous) growth on your conjunctiva — the thin, clear membrane that protects the white part of your eye. It’s not a symptom of cancer and doesn’t mean you have (or will develop) cancer.

The conjunctiva protects and lubricates your eye. It’s a barrier between your eye’s vulnerable tissues and the outside world. The conjunctiva covers the white of your eye (your sclera).

Conjunctival cysts form on the conjunctiva itself and are filled with fluid. Depending on how big it is, you might never have any symptoms or even notice you have a conjunctival cyst. If you do have symptoms, it might feel like there’s something stuck in your eye. It might feel uncomfortable when you blink and move your eye, too.

Some people are born with conjunctival cysts, and others develop them randomly with no cause (idiopathically). They can also be caused by anything that irritates your eye, from certain health conditions to allergens.

Visit your eye care specialist if you notice any changes in your eye, or feel like something is stuck in it.

Conjunctival cyst types

There are two types of conjunctival cysts:

• Inclusion cysts: Inclusion cysts happen when a layer of your conjunctiva folds over onto itself. A cyst forms around the bump and fills with fluid as a response to the irritation. More than 80% of conjunctival cysts are inclusion cysts.
• Retention cysts: Retention cysts form when one of the tiny ducts in your conjunctiva gets clogged by something like an allergen, dust or debris. A cyst forms around the blockage filled with cells and fluid from your lymphatic system.

Who gets conjunctival cysts?

Anyone can develop a conjunctival cyst. They’re more common in people older than 45.

What are the symptoms of a conjunctival cyst?

Many people don’t experience symptoms of a conjunctival cyst, especially if it’s very small. You might not even know you have one until your eye care specialist notices it during your routine eye exam.

If you have a larger cyst, your symptoms can include:

• Feeling like something is stuck in your eye, especially when you’re moving your eye.
• Eye pain.
• Difficulty or discomfort when you move your affected eye.
• Difficulty closing your eye or blinking freely.
• Bulging eyes (proptosis).

It might feel like the cyst is on the inside of your eyelid. This is because you’ll probably only notice it when you blink and your eyelid passes over it.

It’s rare for conjunctival cysts to affect your vision, but you might experience double vision (diplopia) if the cyst is big enough to impact your eye’s ability to move.

What causes conjunctival cysts?

Conjunctival cysts can be caused by anything that irritates your eyes. Some of the most common causes include:

• Conjunctivitis (pink eye).
• Pyogenic granuloma.
• Dry eye.
• Traumas and eye injuries.

Conjunctival cysts sometimes develop after you have surgery on your eye, including procedures to treat:

• Strabismus (crossed eyes).
• Cataracts.

Conjunctival cysts can also be congenital, which means you’re born with them.

How are conjunctival cysts diagnosed?

Your eye care specialist will diagnose a conjunctival cyst with an eye exam.

They should be able to see the cyst when they’re looking at your eye. They might perform a slit lamp exam to measure the cyst. You’ll probably also need a visual acuity test to make sure the cyst isn’t affecting your vision.

You might need an ultrasound of your eye and the tissue around it to check for other growths that aren’t visible on the outside of your eye.

Your eye care specialist might biopsy the cyst to rule out infections or other conditions that could have caused it. A biopsy can help confirm that the growth is a conjunctival cyst instead of another type of cyst, including:

• A sebaceous cyst.
• A dermoid cyst.

How are conjunctival cysts treated?

Many conjunctival cysts don’t need treatment, especially if the cyst is small and isn’t causing you any symptoms.

Your eye care specialist will monitor it with regular eye exams. They might suggest you use at-home treatments like over-the-counter (OTC) eye drops or prescription corticosteroid drops to keep your eye lubricated and prevent inflammation.

If you’re experiencing symptoms and the cyst doesn’t go away on its own, you’ll need it removed. Your ophthalmologist will perform one of two options to remove a conjunctival cyst:

• Aspiration: Your ophthalmologist will puncture the cyst with a tiny needle and drain the fluid out of it. They’ll numb your eye and the area around it with a local anesthetic before aspirating the cyst. Aspiration is less invasive than surgically removing a cyst, but there’s a higher chance it will come back (recur).
• Excision: An excision is the medical term for surgically removing tissue. Your ophthalmologist will numb your eye, and cut the cyst away from your conjunctiva.

How long does it take to recover from having a conjunctival cyst removed?

You’ll need a few days to recover after an aspiration or excision. Your ophthalmologist will tell you which activities to avoid and when you can resume your usual routine.

There’s still a chance a conjunctival cyst will grow back, even after it’s removed. Your eye care specialist will tell you how often you’ll need follow-up eye exams to monitor your eye and check for new growths.

How can I prevent conjunctival cysts?

You can’t prevent a conjunctival cyst from forming. In general, make sure you always wear protective eyewear and proper safety equipment while working with tools or doing any activity that could injure your eyes.

What can I expect if I have a conjunctival cyst?

You should expect to make a full recovery from a conjunctival cyst, even if you need surgery to remove it.

A conjunctival cyst shouldn’t have any impact on your vision or eye once it’s treated.

There’s a chance the cyst will reform, or that a new conjunctival cyst will grow — especially if the original cyst was caused by an irritation like an allergen.

When should I see my healthcare provider?

See your healthcare provider as soon as you notice any changes in your eyes or vision.

Go to the emergency room if you have any of the following symptoms:

• A sudden loss of vision.
• Severe eye pain.
• You see new flashes or floaters in your eyes.

What questions should I ask my doctor?

• What type of growth is in my eye?
• Will I need treatment?
• How long will it take for the cyst to go away?
• If I need the cyst removed, will I need aspiration or excision?

What is the difference between a conjunctival cyst, pterygium and a pinguecula?

Conjunctival cysts, pinguecula and pterygium are all growths on your conjunctiva.

Conjunctival cysts are small bumps that form anywhere on your conjunctiva. They can develop on their own randomly, or be caused by something irritating your conjunctiva. Most conjunctival cysts won’t cause pain, but you’ll be able to feel them when you move your eye or blink.

Pterygium (surfer’s eye), is a fleshy growth on your conjunctiva that has many blood vessels in it. It’s usually shaped like a triangle that starts in the outside corner of your eye and spreads into the center. It may remain small or it can grow and spread onto the cornea.

Pinguecula are raised yellowish or white growths. They stay on your conjunctiva and don’t spread or overlap onto your cornea. They usually don’t cause symptoms or need to be removed.

A note from Cleveland Clinic

It’s always uncomfortable to feel something in your eye. That discomfort is usually the worst part of having a conjunctival cyst. Depending on what caused the cyst to grow, there’s a good chance you won’t need any treatment beyond a few visits to your eye care specialist to make sure it’s going away on its own. If you do need the cyst removed, you should only need a few days to recover and get back to your daily routine.

Talk to your eye care specialist as soon as you notice any changes in your eye, especially if it feels like there’s something stuck in it.