Conjunctival Cysts (Eyeball Cysts): Causes, Diagnosis, and Treatment

Conjunctival cysts are small, fluid-filled sacs that form on the conjunctiva, a thin membrane inside the eyelid that covers the white part of the eyeball. 

Caused by various eye irritations (smoke, too much eye rubbing, or an eye injury), conjunctival cysts are typically harmless and painless. They usually dissipate on their own but sometimes require treatment.

Treatments include home remedies, antibiotic drops, steroid drops, and surgery.

What Are Conjunctival Cysts?

Conjunctival cysts are small, fluid-filled sacs that can form anywhere on the conjunctiva, the thin membrane lining the inside of the eyelid and covering the white part of your eyeball. 

Conjunctiva comprises a mucous membrane, which lubricates the eye, and a stratified squamous epithelium that prevents foreign bodies from entering the eye. It also contains many blood vessels that provide nutrients to the eyes and lymphatic vessels in its surface epithelium for fighting infections and chronic conditions.

Conjunctival cysts are typically split into the following four groups:

• Congenital: People are born with these. 
• Spontaneous: Cysts in this group appear due to a cause the patient can’t identify. 
• Inflammatory: Illnesses that cause swelling can lead to these cysts. 
• Injury: Surgeries, accidents, or other forms of trauma can result in cysts.

Cysts can present as a single cyst or multiple cysts that usually appear as a fluid-filled sac. Sometimes, they look more like a solid mass.

Eye cysts are usually asymptomatic and do not require treatment. But when cysts are large enough and cause symptoms, they must be removed.

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Causes of Conjunctival Cysts (Eyeball Cysts)

Many factors may cause a conjunctival cyst. Some people are born with conjunctival cysts that remain dormant until an injury, surgery, ongoing inflammation, or an allergen triggers them. Others develop them later in life.

Common causes of conjunctival cysts include the following:

• Genetics 
• Conjunctival inflammation 
• Traumatic injury 
• Cataracts
• Strabismus 
• Eye surgery 

Symptoms of a Conjunctival Cyst 

Eye cysts are usually asymptomatic and do not require treatment. But when cysts are large enough and cause symptoms, they must be removed.

Typical symptoms of larger conjunctival cysts include the following:

• Irritation and teary eyes
• The feeling that something is stuck in the eye
• Discomfort when blinking
• Redness or swelling of your eye
• Difficulty closing your eyes
• Itchiness
• Dry eyes when the cysts become too large

Conjunctival Cyst Diagnosis 

Doctors diagnose conjunctival cysts based on information gleaned from your medical history, a physical eye examination, and other tests.

Your medical history provides information about past conditions that can cause eye irritation, redness, and discharge. 

When looking for conjunctival cysts, ophthalmologists perform a physical examination and run one or more tests. Eye doctors use special tools like a slit lamp microscope, which uses high-intensity light focused through a particular lens to closely view the conjunctiva and detect any small cysts not visible during standard eye exams.

Doctors like to rule out other eyelid disorders, such as blepharitis, rosacea, conjunctivochalasis, pinguecula, and meibomian gland dysfunction. They may use a fluorescein stain to help distinguish among them.

An ophthalmologist also may perform a cyst biopsy, gently scraping cells from the cyst for examination under a microscope (cytology). A biopsy is the only way to ensure that the cyst isn’t a symptom of anything dangerous, including cancer.

Conjunctival Cyst Treatments 

Conjunctival cysts sometimes disappear on their own. Doctors often urge patients to wait and see if this occurs. But if you don’t get better, several treatment options exist. 

Home Remedies

Your doctor may recommend the following home remedies:

• Warm compress can help drain out the pus in the cyst and improve blood circulation to the area.  
• Avoid rubbing or touching your eyes with dirty hands, leading to infection and worsening your condition.

Medical Treatments

If home remedies don’t work, your ophthalmologist may prescribe eye drops to reduce swelling and keep your eyes comfortable. 

Surgical Treatments

Your doctor may recommend surgery if your cyst causes significant discomfort or affects your vision. 

During surgery, doctors make a small incision on the surface of your eye to puncture and remove the cyst. No stitches are typically required, but your eye may bleed. A thick pad can protect the site as it heals.

You’ll go home the same day with instructions and eye drops. Keep the eye clean by patting the area with warm water on a washcloth or cotton pad. Use over-the-counter pain relievers, as needed, and follow your doctor’s instructions regarding eye drops and follow-up visits. 

Eyeball Cyst vs. Eyelid Cyst 

To an untrained eye, eyeball and eyelid cysts might seem the same, but they are very different. This table can help you understand how they vary:

Eyeball Cyst	Eyelid Cyst
The eyeball cyst is a benign tumor that forms on the eye’s conjunctiva.	An eyelid cyst is a small, fluid-filled sac on the edge of your eyelid that forms near the base of your eyelashes.
Eyeball cysts can affect vision, cause pain, and increase pressure within the eye.	Eyelid cysts can be unsightly but do not usually harm vision.
Eyeball cysts are caused by genetic defects, inflammation, or trauma.	Eyelid cysts form when the meibomian glands in eyelids become blocked.
Eyeball cysts may require surgery to prevent blindness, infection, and other complications.	Eyelid cysts often go away without treatment but may need to be drained if they become infected or cause discomfort.
Eyeball cysts are more common in adults.	Eyelid cysts are more common in children.

Conjunctival Cyst Prevention

You can prevent conjunctival cysts from occurring and recurring by keeping the eyes clean and free of debris that could injure the conjunctiva or cause an infection. 

The following tips may help:

• Avoid rubbing and touching your eyes with your fingers.
• Keep towels and washcloths clean.
• Get quick care for eye infections.
• See your eye doctor regularly.
• Wear eye protection when you’re doing dangerous things, like playing contact sports. 

If you have had a conjunctival cyst, you should keep your eyes clean and talk to your doctor about any other potential risks you might face.

When Should I See a Doctor?

Contact your doctor if you see a new lump or bump on your eye. The cyst may not need treatment right away, but your doctor may want to monitor its progress and ensure you heal properly.

Visit a doctor immediately if you notice pain or changes in your vision. 

FAQs About Conjunctival Cysts 

References

1. The Conjunctiva. (June 1973). International Ophthalmology Clinics.

2. Conjunctival Inclusion Cyst. (May 2023). American Academy of Ophthalmology.

3. A Rare Case Report of Conjunctival Cyst. (November 2015). Journal of Clinical and Diagnostic Research.

4. Conjunctival Cyst. Columbia University Irving Medical Center.

5. Eyelid Disorders: Diagnosis and Management. (June 1998). American Academy of Family Physicians Journal

6. What Can I Expect When They Do a Biopsy for a Cyst on the Surface of My Eyeball? (March 2013). American Academy of Ophthalmology.

7. Eye Cyst Removal. (May 2022). NHS Foundation Trust.