Conjunctival Inclusion Cysts in Long-standing Chronic Vernal Keratoconjunctivitis

To report a case of conjunctival inclusion cysts on the corneal limbus of a patient with chronic vernal keratoconjunctivitis during 16 months' follow up.

The patient was a 26 year old male without any specific history of surgery or trauma. Giant papillae, shield ulcers, and Horner-Trantas dots were detected. During the 16 month follow-up, Sodium cromoglycate eye drops and Prednisolone acetate 1% eye drops were given 3 times a day. During this period, conjunctival cysts were detected on the corneal limbus in both eyes. In spite of improvement of the corneal and conjunctival conditions, the conjunctival cysts did not seem to show any specific changes. For relief of foreign body sensation, excision of the conjunctival cysts and giant papillae of the left eye and histopathologic examination of the specimen was performed.

On histopathological examination, the conjunctival cysts consisted of nonkeratinizing stratified epithelial cells filled with PAS-positive mucous substance. Inflammatory cells were not found in the vicinity.

Conjunctival inclusion cysts can be seen as an atypical finding of long-standing vernal keratoconjunctivitis. Mechanical friction between the giant papillae and conjunctiva may be a factor in inducing the formation of the conjunctival cysts.