Clinical characteristics and treatment outcome of conjunctival myxoma

Conjunctival myxoma is a rare benign mesenchymal tumour frequently misdiagnosed as conjunctival cysts, lymphangiomas, or other similar lesions. This study aims to characterise the clinical profile and treatment outcomes of conjunctival myxoma at a single tertiary centre.

We retrospectively reviewed records of patients with histopathologically confirmed conjunctival myxoma treated at Zhongshan Ophthalmic Center between January 2021 and December 2024. Data collected included primary symptoms, tumour location (temporal, nasal, superior, inferior), anatomical involvement (eyelid, conjunctiva, orbit), size, shape, and colour. Ultrasound biomicroscopy and MRI were performed when indicated. All patients underwent complete local excision. Follow-up data were obtained from clinic visits and telephone interviews as of March 4, 2025.

The eyes of 13 patients were identified. Mean age was 41.6 ± 3.9 years; nine patients (69.2%) were female. Median follow-up was 32.8 months (range, 1-84). All presented with painless, slow-growing, mobile conjunctival masses. Most lesions were dome-shaped, yellowish-pink, cystic-translucent, with well-defined margins. Primary symptoms included ocular redness (5/13), pain (2/13), and pruritus (1/13). All cases were unilateral, predominantly affecting the nasal conjunctiva (7/13). Twelve lesions involved the bulbar conjunctiva; two extended into the orbit, and one involved the inner canthus. No recurrences were observed.

Conjunctival myxoma is a benign tumour typically affecting the bulbar conjunctiva, more common in females, and usually unilateral. Imaging aids differential diagnosis, while pathology remains essential for confirmation. Microsurgical excision yields excellent outcomes with low recurrence.