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This is a PatientPlus article. PatientPlus articles are written for doctors and so the language can be technical. However, some people find that they add depth to the articles found in the other sections of this website which are written for non-medical people.
Corneal Microcysts
Post your experienceThese are tiny cystic vesicles present on the outer (epithelial) surface of the cornea. They can arise in a number of different conditions:
- Associated with certain types of contact lens1
- Associated with recurrent corneal erosion syndrome2
- In the presence of vapours of certain industrial chemicals e.g. aliphatic, alicyclic and heterocyclic amines3
- Associated with certain corneal dystrophies (epithelial basement membrane dystrophy - EBMD or Cogan's microcystic corneal dystrophy and Meesmann dystrophy)4
- They have been more recently associated with interferon therapy5
- They may be found in pre-invasive carcinoma of the cornea6
This varies with the aetiology, the most common being microcysts associated with contact lens wear.
Some may be asymptomatic. Others may cause ocular irritation or transient blurred vision and - if they rupture - cause painful corneal erosions which show up as punctate epithelial erosions (there will be scattered pinpoints of fluorescein uptake across the corneal surface).
This depends on the underlying cause but generally, these patients are managed in an ophthalmology clinic. The source is removed where possible (such as in the case of contact lenses) and intensive lubrication with the aim to limit cyst formation and rupture is the mainstay of treatment.
If they persist and repeatedly rupture, they may be treated as would a case of recurrent corneal erosion syndrome i.e. topical chloramphenicol, lubricants and - if there is no improvement - a period wearing a bandage contact lens (a soft lens with no refractive power that sits over the cornea and protects it from the shearing forces of the blinking lids).7 In severe cases, focal debridement may be required.
If they fail to heal adequately, the patient may go on to develop the self perpetuating condition of recurrent corneal erosion syndrome, whereby there is an ongoing cycle of cyst formation and rupture as the epithelium does not have the time to fully heal.
This depends on the cause. Microcysts associated with contact lens wear should settle when the lenses are removed. Microcysts associated with corneal erosion syndrome as is found in dry eye should settle with intensive (and ongoing prophylactic) lubrication. Cysts arising as a result of industrial chemical vapour exposure settle over a few hours after vacation of the vapour with no long-term sequelae. Corneal dystrophies are generally progressive disorders which worsen over time.
Good patient education with regards to contact lens wear, lubrication.
Document references
- Kunimoto DY, Kanitkar KD, Makar MS; The Wills Eye Manual, 4th Edition, 2004, Lippincott, Williams and Wilkins.
- Verma A, Ehrenhaus MP; Corneal erosion, recurrent. eMedicine, April 2008.
- Ballantyne B; Glaucopsia: an occupational ophthalmic hazard. Toxicol Rev. 2004;23(2):83-90. [abstract]
- Kanski J. Clinical Ophthalmology, A Systematic Approach (5th ed.) 2003 Butterworth Heinemann
- Fracht HU, Harvey TJ, Bennett TJ; Transient corneal microcysts associated with interferon therapy. Cornea. 2005 May;24(4):480-1. [abstract]
- Dark AJ, Streeten BW; Preinvasive carcinoma of the cornea and conjunctiva. BJO 1980; (64): 506-514
. - Jackson TL. Moorfields Manual of Ophthalmology, 2008, Mosby.
DocID: 1661
Document Version: 21
DocRef: bgp1908
Last Updated: 13 Jan 2009
Review Date: 13 Jan 2011
The authors and editors of this article are employed to create accurate and up to date content reflecting reliable research evidence, guidance and best clinical practice. They are free from any commercial conflicts of interest. Find out more about updating.
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