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

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

Caused by various eye irritations (smoke, too much eye-rubbing or an eye injury), they 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.

Intro

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

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.

Being on your outer eye, the conjunctiva is especially vulnerable to injuries. 

Many factors may cause a conjunctival cyst, including inflammation, trauma and genetics. There are two main kinds of conjunctival cysts, and each has a different cause:

• Retention cyst. Results from a blocked duct, which leads to a buildup of eye secretions. This buildup creates a cyst.
• Inclusion cyst. This type of Conjunctival cysts occurs when a piece of epithelium tissue (the top layer) of your conjunctiva folds into the connective tissue of your conjunctiva.

Some people are born with conjunctival cysts, although they remain dormant until an injury, surgery, ongoing inflammation or an allergen triggers them.

Eyeball cysts are common in people who are 50 and older, although in rare cases children can also develop them.

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 need to be removed.

Causes of Conjunctival Cysts (Eyeball Cysts)

The most common causes for conjunctival cysts are:

• Irritating substances such as smoke, chemicals, or cosmetics
• Eye surgery such as cataract removal surgery
• Injury
• Rubbing your eyes too much
• Contact lens use.
• Infections such as pink eye
• Genetics (an inherited condition)

Symptoms of Conjunctival Cyst

Conjunctival cysts develop with few if any noticeable symptoms, particularly in early stages. If you look closely at your eyes a lot, there is a chance you will notice if you have one. You can see a clear blister or bubble on your eye.

You may also experience other symptoms as the conjunctival cyst grows. Symptoms depend on the location and size of the cyst, and typical symptoms of larger conjunctival cysts include:

• 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 examination of the eye and an eye biopsy.

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 runs one or more tests. They use special tools like a slit lamp microscope, which uses a high-intensity light focused through a particular lens to view the conjunctiva closely and to 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 (MGD). They may use a fluorescein stain to help distinguish among them.

The 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. Meanwhile, you can apply home remedies to help improve the condition of the eye.

Home Remedies

Your doctor may recommend the following home remedies:

• Warm compress to 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:

•  Antibiotics or steroid eye drops
•  Artificial tears or medicated eye drops to relieve irritation and reduce inflammation

Surgical Treatments

Surgical removal of the cyst is typically a last treatment option, but doctor may recommend it if your cyst causes significant discomfort or affects your vision. Doctors perform the outpatient procedure under general anesthesia, but it could be done under local anesthesia if it’s a minor procedure. An antibiotic ointment will be applied to your eye during surgery to reduce the risk of infection.

Surgeons make a small incision on the surface of your eye to remove the cyst. If there are any stitches, they will dissolve on their own. Your doctor will prescribe antibiotic drops after surgery to prevent infection.

Cysts that recur after surgical removal are removed through cryosurgery (freezing), which is a less-invasive and less-expensive option than surgical excision. It may require several treatments to be effective.

Your doctor also could recommend high-frequency radio-wave electrosurgery to remove conjunctival cysts.

Eyeball Cyst vs. Eyelid Cyst

To an untrained eye, eyeball cysts and eyelid cysts might seem the same. In fact, there is a big difference between the two.

An eyeball cyst is a fluid-filled sac that develops on the eye’s outer surface. In contrast, eyelid cysts are fluid-filled sacs that form under the eyelid. The table below shows the difference between eyeball and eyelid cyst.

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 the pressure within the eye.	Eyelid cysts can be unsightly but do not usually harm vision or cause pain.
Caused by genetic defects, inflammation or trauma to the eye	Forms 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. Some tips:

• Avoiding rubbing and touching your eyes with your fingers.
• Avoid wearing contact lenses for an extended time and when there are signs of ocular conditions.
• Avoid dirty towels or washcloths on your face, especially your eyes.

If you have had a conjunctival cyst in the past, you should keep your eyes clean and talk to your doctor about any other potential risks that you might face. If you have glaucoma or cataracts, you are more likely to suffer a conjunctival cyst than someone without the conditions.

It is also essential to treat all eye infections immediately, especially in children, who tend to be more resistant to medication than adults.

FAQs

What is an eyeball cyst?

An eyeball cyst is a fluid-filled sac on the surface of the eye. In most cases, these cysts are not painful and are not serious. However, they may need to be drained if they get large enough to cause discomfort or interfere with vision.

Do eyeball cysts go away?

Yes. Eyeball cysts can go away on their own. That said, you can also try home remedies and prescription medication to speed up the process. If they don’t go away or keep recurring, seek an ophthalmologist’s help for more attention.

How do you treat a cyst on your eyeball?

The treatment of a cyst depends on its size and duration. Doctors recommend using non-surgical treatments before attempting surgery. These include warm compresses, antibiotics ointments, steroid drops and artificial tear drops.

References

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4. A rare case report of conjunctival cyst. (November 2015). Journal of Clinical and Diagnostic Research.

5. Cornea and external diseases: Tumors – conjunctival cysts. (Date accessed March 2022). Columbia University Department of Ophthalmology.

6. What is an Ophthalmologist? (January 2022). American Academy of Ophthalmology.

7. Eyelid disorders: diagnosis and management. (June 1998). American Academy of Family Physicians Journal

8. What can I expect when they do a biopsy for a cyst on the surface of my eyeball? (March 2013). American Academy of Ophthalmology.

9. Use of steroid eye drops in general practice. (May 1986). The British Medical Journal.

10. A Novel Technique to Treat a Recurrent Giant Conjunctival Cyst. (April 2021). The Journal of Cornea and External Disease.

11. Removal of conjunctival cyst with high-frequency radio-wave electrosurgery. (October 2015) Canadian Journal of Ophthalmology

12. Corneal ulcers associated with daily-wear and ex.tended-wear contact lenses. (July 1986).  American Journal of Ophthalmology.