Retention/Inclusion Cyst and Lymphangiectasia

Dr Ben Wild

Overview

The conjunctiva is a clear layer of tissue that extends from the edge of the cornea, around the visible portion of the eye in front of the white sclera, and even covers the back surface of the eyelids. It posses as a barrier against foreign material contributes to the tear film.

A frontal view of a healthy eye.

Retention (or inclusion) cysts and lymphangiectasias represent thinly walled lesions over the white part of the eye (sclera), containing either clear or semi-clear fluid. Theses cysts can be bilateral (both eyes) or unilateral (one eye) and do not often cause any discomfort.

A sagittal view of an eye with a retention cyst.

Retention cysts represent very common single entities of fluid build up under the conjunctiva whereas lymphangiectasias, which can be single cysts, tend to be sausage-link like channels of cysts. They are much less common and thought to be a build up of fluid from blocked lymphatic channels. Both of these tend to resolve spontaneously but can remain chronic.

Signs and Symptoms

Signs

Clear/semi-clear fluid filled cyst over the white parts of the eye.

Symptoms

Usually none but sometimes minor irritation and foreign body sensation.

Causes and Risk Factors

Causes

Usually idiopathic (no cause).

Risk Factors

Ocular inflammation, allergies, and/or trauma.

Prevention and Treatment

Prevention

There are no known preventative measures.

Treatments

· Artificial tears for discomfort since they can resolve on their own.

· Puncture with needle (tend to recur).

· Cyst wall excision (tend not to recur).

Prognosis

Neither of these conditions are vision threatening and represent only minor inconveniences to day-to-day life. They tend to be seen as cosmetic blemishes rather than true ocular conditions.