There has been an incessant cases of conjunctival cyst among American citizens. A cyst is an abnormal sac-like tissue which contains fluid, air or semisolid substances. It can develop anywhere in the body. Whenever there is a blockage of a glandular cell or organ, the accumulation of fluid produces a cyst. Cysts vary in size as well, some could be microscopic while others are very large.
DIFFERENT TYPES OF CYST
Some types of cyst include: Baker’s cyst, ovarian cyst, perineural cyst, branchial cleft cyst, mucous cyst, ganglion cyst, Pilar cyst, Conjunctival cyst etc.
Cysts are not harmful except they are very large , infected, in a sensitive organ or affecting the function of an organ or interfering with a nerve or blood vessel. Cysts can be caused by a whole lot of things, such as; blockage of ducts, Infections, chronic inflammation, clogged sebaceous gland, genetic conditions, piercings, tumors, genetic condition, defects in organ during intra-uterine life, cell defect, a parasite. Cysts are mostly benign but in some cases they can also be malignant ( cancerous).
WHAT DO WE MEAN BY CONJUNCTIVAL CYST?
Conjunctival cyst is an infection of the eye . This infection creates a thin-walled sac wall containing fluid in the eye, giving it a semblance of a blister on the skin. It could appear on the upper surface or below the conjunctiva.
The conjunctiva is the membrane that covers the eyeballs and lines the eyelid as well as the sclera (the tough, white, outer layer of the eyeball) and close to the edge of the cornea.
Most importantly, the conjunctiva covers the white area of the eyeball, it serves as a safety barrier that does not let external particles or germs get into the eyes. It also keeps the eye moist and this can be considered it’s two vital functions of the eye.
For the eye to function optimally, a healthy conjunctiva is a necessity. This is as a result of the fact that it helps to create a suitable environment for the cornea, which is responsible for focusing most of the light that enters the eye.
It helps protect the eye serving as a barrier between microorganisms and foreign bodes from the external environment. It also helps maintain the tear film and dry eye syndrome. Because of the availability of many small blood vessels, the conjunctiva is able to provide important nutrients to the eye and eyelids.
PARTS OF CONJUNCTIVA
The Conjunctiva has two parts which are:
(1) Bulbar conjunctiva
This portion of the conjunctiva covers the anterior part of the sclera. The bulbar conjunctiva stops at the junction between the sclera and cornea. It does not cover the cornea. This part of the conjunctiva covers the anterior part of the sclera. The bulbar conjunctiva terminates at the junction between the sclera and the cornea; it does not cover the cornea
(2) Palpebral conjunctiva
This portion covers the inner surface of both the upper and lower eyelids. The bulbar and palpebral conjunctiva are continous. Palpebral conjunctiva (Lid conjunctiva) is that part that covers the inner surface of both the upper and lower eyelids. The fornix is where the eyeball cover meets the eyelid cover. The tissue in these areas is loose and soft, allowing the eye to move freely. Some conjunctival cysts are prone to appear in this area.
SYMPTOMS OF CONJUNCTIVAL CYST
A conjunctival cyst is an asymptomatic ailment, this means that there are little to no symptoms to a person infected with this ailment especially at the initial stage of the development. Rarely, the cysts may cause blurred vision or affect how well your eyeball moves.
At the extreme stage, a person who is infected with conjunctival cyst will experience some symptoms which include:
(1) Dryness and itchiness in the eye
(2) Inflammation at the external surface of the eye or eyelid
(3) Complications in the blinking eye
(4) Burning sensation with fluid filled bubble on eyeball
TYPES OF CONJUCTIVAL CYST
The conjuctival cyst consists of two types which are:
A. Inclusion conjunctival cyst
The inclusion conjunctival cyst occurs when the epithelium tissue at the top conjunctival layer folds into and touches the connective tissue of the conjunctiva.
B. Conjunctival retention cyst
This occurs due to a blockage of the ducts which further causes eye secretions and these secretions are the main cause of the cyst. There are also pigmented and non pigment cystic lesions that can arise congenitally or as quiet conditions of the conjunctiva.
CAUSES OF CONJUCTIVAL CYST
Some of the cases of conjunctival cysts arise congenitally, meaning they are present at birth. They usually occur at the fornix, where the eyelid membrane joins with the eyeball membrane. They are generally slow-growing and may never be noticed for years.
Other causes of conjunctival cysts may be as a result of trauma to the eye. They can result from eye surgery, particularly cataract surgery. They can also be caused by certain parasites. They may be caused by folding of the conjunctival crypts or secondary to inflammation. Also, chemicals, allergies, and dry air can cause irritation of the conjunctiva and lead to conjunctival cysts.
TREATMENT OF CONJUNCTIVAL CYST
If a conjunctival cyst is present, it is necessary not to rub, touch, or try to rupture it as this will cause further irritation. Also, they are very tiny blood vessels you might not want to rupture. Yes, you may feel uncomfortable when you blink because the cyst can be felt at this point, but it is better you don’t rub it at all.
In some instances, no treatment is required and they get resolved by themselves with time but some cases require proper treatment through medication or surgical excision. Here are some of the treatment options for conjunctival cyst
1. Use of Antibiotics: Antibiotic eyedrops can be recommended to prevent the cyst from growing and to help combat the infection.
2. Application of Heat: This can be achieved by placing a warm towel on or near the affected area of the eyelid. This is useful because it can give relief and may sometime help to release the contents of the cyst itself.
3. Surgery: Conjunctival cyst can be removed surgically in a procedure known as incision and curettage. This is usually the last point of call where the cyst has refused to go on it’s own and is resistant to the antibiotics.
This procedure involves making a small incision into the cyst itself and then removing the contents within a sterile environment. For this surgery to be carried out, local anasthesia is administered to the eye usually in form of eye drops or injections. This anasthesia may cause a lot little stinging effect for a short time.
You will be awake but will feel numbness in the area around your eyelid. In some cases, general anaesthetic is used for the surgery but this will be made known to you by your consultant.
Anasthesia will also been administered and taken full effect on the patient, before the surgeon can then proceeds to delicately cut the cyst open with a surgical blade while using an instrument called a curette to effectively scoop out the contents.
Antibiotics will be given to prevent infection and a patch applied over the eye to arrest any bleeding.
After the surgery, proper rest is recommended to enable you recover. With follow up appointment, the doctor will ascertain when you can resume normal activities and give you instructions that will aid recovery.
4. Alternatively, conjunctival cyst can also be removed by doctors: The cyst can also be completely removed. To ensure the blood vessels are completely sealed off, the wound is then cauterized (burnt) immediately.
They do so by using a dye to show the borders of the cyst so they can remove it totally. Sometimes lasers are used, which are more precise and less invasive than traditional surgical tools. They can do this in their office and without having to use the operating room.
WHAT OTHER DISEASES ARE ASSOCIATED WITH THE CONJUNCTIVA?
1. Conjunctivitis: This is the most frequent disease of the conjunctiva, it is popularly known as the ‘pink eye’. Conjunctivitis is the inflammation of the conjunctiva usually caused by a bacterial or viral infection, allergic reaction. It is contagious and can make the sufferer very uncomfortable.
2. Trachoma: Although it occurs rarely, this is a bacterial infection that affects the lining of the conjunctiva giving it a reddish appearance while causing the cornea to appear gray. With time the tissue of the he conjunctiva looks like there are grains of sand .
3. Tarsal Conjunctival Disease: When the palbebral conjunctiva and tarsus is inflamed with formation of scar and fibrovascular proliferation, it is known as a tarsal- Conjunctival diseas.
Conjunctival cysts forms on the conjunctiva, it could start as a small fluid filled sac and begin to grow from there. Conjunctival cyst can occur congenitally, people from the age of 47 of both sexes stand a chance of getting infected especially with the inclusion cyst which has a prevalence of 80% as compared to there kinds of cyst. Sometimes they go away on their own but sometimes surgery and other treatments are required to treat it properly.
1. Morris Fishbein M.D(1963).Illustrated Medical and Health Encyclopedia. Volume 3 and 4. H.S. Stuttman and co publishers. New York, USA.
2. “Conjunctival Cysts: What Causes Them and How They Are Treated” https://www.webmd.com/eye-health/what-is-conjunctival-cyst