|Year : 1983 | Volume
| Issue : 1 | Page : 1-4
Cystic lesions of conjunctiva
K Nath, R Gogi, Nahid Zaidi, Anil Johri
A.M.U. Institute of Ophthalmology, Aligarh, India
A.M.U. Institute of ophthalmology, Aligarh-202 001
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Nath K, Gogi R, Zaidi N, Johri A. Cystic lesions of conjunctiva. Indian J Ophthalmol 1983;31:1-4
After reviewing the available literature it was found that apart from the studies of Norn and Mortada very little work has been documented on cystic lesions of conjunctiva.
The present study consists of forty-five histopathologically examined cystic lesions of conjunctiva.
| Materials and methods|| |
In the present study, forty-five cystic lesions of conjunctiva from the in and out-patient departments of A.M.U Institute of Ophthalmology and Gandhi Eye Hospital, Aligarh, were included. Each case was examined clinically and. investigated. The cysts were surgically treated and histologically examined.
| Observations and discussion|| |
Forty five cases of cystic lesions of conjunctiva were studied in 24 males and 21 females. Majority of the cases belonged to second decade followed by first and third decade of life [Table - 1]. Various types of cysts recorded are shown in [Table - 2].
There was no definite history of trauma or operative interference in any of the cases.
1. Epithelial Inclusion Cysts
The inclusion cysts were the commonest cystic lesions of conjunctiva. The size of the inclusion cysts varied from 0.5 cm to 2.5 cm. X 1.5 cm. The cysts were located in upper fornix (15), lower fornix (6) and in bulbar conjunctival cysts were lined by double layer of flattened epithelium and the lumen was empty. There was associated chronic inflammatory reaction in the surrounding areas [Figure - 1]A,B.
Absence of history of trauma has led to the view in the past that these cysts are of nontraumatic origin,. This however, does not rule out the incidence of mild trauma to the conjunctival tissue about which the patient may not be aware of. We feel inclined to suggest that in normal conjunctiva a. mild degree of trauma may not lead to embedding of conjunctival epithelium into the deeper tissues. Once there is conjunctival inflammation, the epithelium becomes loose and the deeper tissues get oedematous, with mildest trauma the epithelial cells may get exfoliated and burned into the deeper tissues where mild fibrosis, shallowing of fornices and adhesions may be progressing slowly. Proliferation of these cells results in the formation of cysts. Hence simultaneous occurrence of inflammation and trauma may contribute to its genesis.
The dermoids were situated either at the limbus (5 cases) or at the lateral canthus (3 cases). The size of dermoids varied from 0.3 cm X 0.2 cm, to 2.0 cm X 1.0 cm. [Figure 2]. They were spherical with smooth surface. In order to prevent symblepharon formation ring prosthesis was used during the post operative period `r. The cut surface of the cyst contained cheesy material and hair shafts. Histopathologically their wall was linned by stratified squamous epithelium. The lumen contained granular kerttin material. The sub-epithelial zone showed the presence of hair follicles, sweat and sebaceous glands [Figure - 1]C,D.
3. Parasitic Cysts
The size of the parasitic cysts varied from 0.3 cm. X 0.5 cm. to 1.0 cm X 1.0 cm. Their shape was circular or oval. These looked whitish with a chalky white spot in the cavity representing the scolex of the parasite. It was interesting to note that in all these cases the left eye was involved with a predisposition to nasal side. This may be explained on the basis of anatomical reasons,.
In one case the cyst was found partly prolapsed from the subconjunctival tissue. No obvious cause for the spontaneous expulsions could be elicited. However, mechanical stretching due to the presence of the cyst and weak conjunctiva (due to associated inflammation) could possibly explain the spontaneous expulsion. All other cysts were surgically removed. Histopathological examination of these cases showed the body canal of cysticercus cellulosae lined by the epithelium [Figure - 1]E.
4. Lymphatic Cysts
The size of lymphatic cysts varied from 0.2 cm X 0.4 cm 0.5 cm X 0.5 cm. The cysts were present under the bulbar conjective (3 cases) and upper fornix (I case). The cysts were transparent, multilocular and filled with clear fluid. In one case the cyst was pedunculated. Histopathologi
cal examination showed dilated lymphatic spaces lined with endothelium. The dilated lymphatics which can not be emptied are considered to develop into lymphatic cysts [Figure - 1]F
5. Pigmented Cysts
In one case the lesion was localized to the medial part of conjunctiva and was cystic whereas in the second case sclera and the lids were also involved alongwith the conjunctival lesion, which was cystic at places (oculo-dermal melanocytosis complex). Histopathological examination revealed the presence of aggregates of melanocytes under epithelium with a tendency to form adenomatous arrangement. [Figure l] G.H.
| Summary|| |
It is a clinicopathological study of 45 cases of cystic lesions of conjunctiva. These lesions are most common during first three decades of life. Epithelial inclusion cysts occupied the major bulk (27 cases).
| References|| |
Norn, M.S. 1952, Act. a Ophthalmol. (Kbh), 37:172.
Mortada, A., 1966, Bull. Ophthalmol. Soc., Egypt., 59:63
Brounell, R.D., 1960, Amer. J. Ophthalmol., 49:151.
Nath, K., Gogi, R., and Zaidi, N., 1979. Ind. J. Ophthalmol., 1:49.
Rao, A.U.N., Satyendran, O.M. and Socd,N,N. 1967, Orient. Arch. Ophthalmol., 15:249.
Malik, S.R.K., Gupta,. A.K., and Chaudhari, S.K., 1968, Amer. J. Ophthalmol., 66:1168.
Shrivastava, U.S., Gogi, R. and Johri, A., 1980, Ind. J. Ophthalmol., 28:31.
[Figure - 1]
[Table - 1], [Table - 2]