Conjunctival Epithelial Inclusion Cyst following Evisceration with Primary Orbital Implantation

A 29-years-old Turkish man who had undergone evisceration with primary orbital implantation 20 months prior complained of difficulty wearing his artificial eye. Slit-lamp examination revealed a conjunctival cyst in the center of the anophthalmic socket, with no evidence of scleral or orbital implant exposure. The cyst was completely excised under general anesthesia and did not require use of any sclerosing substance or dye. At 6 months postoperatively, there was no recurrence of the cyst or exposure of the sclera or orbital implant. As the upper and lower fornices were sufficiently deep, the patient could wear his artificial eye.

Transconjunctival excision of a conjunctival cyst using computer-assisted 3-D surgical planning in a dog

Investigation of exophthalmos and blood-colored discharge from the left ventral punctum in a dog was consistent with a conjunctival cyst. 3-D prints of the cyst and surrounding facial bones identified a successful transconjunctival approach without an orbitotomy and patency of the left lacrimal duct was re-established.

A case of giant orbital conjunctival cyst mimicking lymphatic malformation

A conjunctival inclusion cyst is a colorless or whitish translucent cystic lesion, frequently occurring on the conjunctiva. Here, we describe a patient with a giant conjunctival cyst, mainly existing in the orbit, which clinically resembled lymphatic malformation. A 34-year-old male complained of a subconjunctival mass on his left infero-medial side persisting since childhood. It had gradually enlarged over the 3 months before the initial visit. He had no history of trauma, surgery, or conjunctivitis. The mass was dark red, with superficial dilated blood vessels. Magnetic resonance imaging showed a well-circumscribed mass in the inferior orbit, measuring 12 × 25 mm, which had an internal septum. The lesion was completely resected without rupture of the mass through a transcutaneous approach. Histopathologically, the mass was a cyst composed of columnar epithelium with goblet cells and lymphoid follicles adjacent to the wall. In conclusion, a giant orbital conjunctival cyst and a lymphatic malformation should be differentiated at diagnosis.

SARS-CoV-2 receptor ACE2 is expressed in human conjunctival tissue, especially in diseased conjunctival tissue

COVID-19 virus has currently caused major outbreaks worldwide. ACE2 is a major cellular-entry receptor for the COVID-19 virus. Although ACE2 is known to be expressed in many organs, whether it is expressed by the conjunctival tissue is largely unknown. Human conjunctival tissues from 68 subjects were obtained, which included 10 subjects with conjunctival nevi, 20 subjects with conjunctivitis, 9 subjects with conjunctival papilloma, 16 subjects with conjunctival cyst, 7 subjects with conjunctival polyps, and 6 ocular traumas as normal subjects. Expression of ACE2 was evaluated by immunohistochemistry, immunofluorescence, reverse transcriptase-quantitative polymerase chain reaction, and western blot assay. We observed the expression of ACE2 by conjunctival tissues, expecially in conjunctival epithelial cells. ACE2 was significantly (p<0.001) overexpressed in conjunctival cells obtained from subjects with conjunctivitis, conjunctival nevi, conjunctival papilloma, conjunctival cyst, and conjunctival polyps epithelial cells when compared to that in conjunctival epithelial cells obtained from control subjects. Collectively, clinical features of reported COVID-19 patients combined with our results indicate that COVID-19 is likely to be transmitted through the conjunctiva.