Conjunctival Epithelial Inclusion Cysts
Conjunctival epithelial inclusion cysts are clear lesions that appear in either the bulbar conjunctiva or the conjunctival fornix and are typically incidental findings on examination (Fig 6-3). As these cysts are usually asymptomatic, they do not require treatment. If the cyst is symptomatic, simple drainage can be attempted; however, recurrence is common because of the epithelium lining the interior of the cyst. Complete excision is necessary to prevent recurrence.
Conjunctival inclusion cysts can be congenital or acquired. Most acquired cysts of the conjunctiva are derived from an inclusion of conjunctival epithelium in the substantia propria. The implanted cells proliferate to form a central fluid-filled cavity that is lined by nonkeratinized conjunctival epithelium. Conjunctival cysts may also form from ductal epithelium of the accessory lacrimal glands; these cysts are lined by a double layer of epithelium. Stimuli for cyst formation include chronic inflammation, trauma, and surgery. Dilated lymphatic channels may mimic an inclusion cyst of the bulbar conjunctiva.
Excerpted from BCSC 2020-2021 series: Section 10 - Glaucoma. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.