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A 64-year-old man with an unusual conjunctival cyst
Digital Journal of Ophthalmology 2017
Volume 23, Number 1
March 8, 2017
DOI: 10.5693/djo.03.2016.04.001
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Seanna Grob, MD, MAS | Department of Ophthalmology, Veterans Affairs Boston Healthcare System, Boston, Massachusetts Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts Department of Ophthalmology, Massachusetts Eye and Ear Infirmary
Daniel R. Lefebvre, MD | Department of Ophthalmology, Veterans Affairs Boston Healthcare System, Boston, Massachusetts Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts Department of Ophthalmology, Massachusetts Eye and Ear Infirmary Ophthalmic Plastic Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts
Nora Laver, MD | Ophthalmic Pathology, Department of Ophthalmology, Tufts Medical Center and Tufts University School of Medicine, Massachusetts
Mary K. Daly, MD | Department of Ophthalmology, Veterans Affairs Boston Healthcare System, Boston, Massachusetts Department of Ophthalmology, Boston University School of Medicine, Boston, Massachusetts Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts



Differential Diagnosis
Conjunctival epithelial inclusion cysts are quite common and are often associated with a site of prior accidental or surgical trauma. Clinically, these lesions are transparent with a cystic elevation on the ocular surface. Histopathological analysis shows these cysts to be lined by conjunctival epithelium. This is similar to our patient, but classically these cysts do not have foreign material within them; however, they can have proteinaceous material or cellular debris. Many of these cysts are just observed clinically, but because the appearance of the cyst in our patient was unusual, with multiple free-floating particles within, an excisional biopsy was recommended.

Sebaceous cysts of the caruncle are keratin-filled cysts and can have a yellow appearance, but the intracystic contents are not as mobile on clinical examination as in our patient. Conjunctival lymphangiectasia is another cause for a transparent, cystic-appearing lesion on the ocular surface. This often appears as multiple small bumps on the surface of the eye and occurs when the lymphatic channels in the conjunctiva become dilated and prominent.
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