conjunctival concretion

What are Conjunctival Concretions?

Conjunctival concretions, also known as "conjunctival stones" or "episcleral nodules," are small, hard lumps that form on the conjunctiva, a clear membrane covering the white part of the eye and lining the inside of the eyelids [9]. These deposits are typically yellowish-white in color and can vary in size [5].

Characteristics

Conjunctival concretions are usually discrete, benign, but sometimes they become confluent [8]. They may be idiopathic or secondary to chronic conjunctival inflammation like in trachoma [11][15]. These deposits typically exist in the subepithelial space of palpebral conjunctiva or fornices [11].

Symptoms

Most individuals with conjunctival concretions are asymptomatic, and the concretions are noted incidentally on ocular evaluation [10]. Some patients may complain of irritation or foreign body sensation [10]. In rare cases, the concretions can cause epiphora (excessive tearing) if they erode through the upper layers of tissue [13].

Prevalence

Conjunctival concretions are more prevalent in elderly individuals and those with a history of chronic conjunctivitis [11][13]. They are usually less than 1mm in diameter, making them difficult to detect without a thorough examination by an ophthalmologist [3].

In summary, conjunctival concretions are small, harmless deposits that form on the conjunctiva, typically in elderly individuals or those with chronic conjunctivitis. While they can be asymptomatic, some patients may experience mild irritation or discomfort.

References: [1] - Not provided [2] - Not provided [3] - 3 (from context) [5] - 5 (from context) [8] - 8 (from context) [9] - 9 (from context) [10] - 10 (from context) [11] - 11 (from context) [13] - 13 (from context) [15] - 15 (from context)

Recognizing the Signs and Symptoms of Conjunctival Concretions

Conjunctival concretions are small, benign deposits that can form on the conjunctiva, a thin, transparent tissue covering the white part of the eye and lining the inner surface of the eyelids. While generally harmless, these concretions can cause discomfort and may raise concerns for those experiencing them.

Common Symptoms:

• Foreign body sensation: The feeling of having something in the eye, often described as a gritty or sandy sensation [9].
• Eye redness: The conjunctiva may appear reddened or bloodshot [9].
• Discomfort and irritation: Individuals with conjunctival concretions may experience discomfort or a sensation of a foreign body in the eye, which can be exacerbated by blinking or eye movements [11].

Visible Signs:

• Small, hard yellow-white deposits: These deposits are commonly seen on the palpebral conjunctiva, usually discrete and less than 1mm in size [6].
• Redness and swelling: In some cases, the concretions may cause redness and swelling of the surrounding tissue [11].

Important Notes:

• Conjunctival concretions are often asymptomatic, meaning they do not cause noticeable symptoms in many individuals.
• When symptoms are present, they can be mild and may not require medical attention.

References:

[6] - Small, hard yellow-white deposits commonly seen in the palpebral conjunctiva; Usually discrete [9] - Foreign body sensation: The feeling of having something in the eye, often described as a gritty or sandy sensation. [11] - Discomfort and Irritation. Individuals with conjunctival concretions may experience discomfort or a sensation of a foreign body in the eye.

Diagnostic Tests for Conjunctival Concretions

Conjunctival concretions, also known as lithiasis, are small white or yellow nodules that can form on the conjunctiva, a thin membrane covering the white part of the eye. Diagnosing these concretions typically involves a comprehensive eye examination by an ophthalmologist.

• Slit Lamp Examination: A slit lamp is a specialized microscope used to closely examine the conjunctiva for the presence of calcified deposits. This test allows the doctor to get a detailed view of the eye and detect any abnormalities, including conjunctival concretions.
• External Ocular Photography: This diagnostic test involves taking photographs of the eye from different angles to help identify any signs of conjunctival concretions.
• Visual Assessment: A thorough visual assessment is also performed during the examination to check for any symptoms or signs of conjunctival concretions.

According to [10], a comprehensive eye examination, including an evaluation of the conjunctiva, eyelids, and tear film, helps identify the presence of concretions and rule out other eye conditions. Additionally, [11] states that healthcare professionals may perform various assessments, including eye examinations, to diagnose conjunctival concretions and assess their impact on ocular health.

In most cases, patients with conjunctival concretions are asymptomatic, and the condition is diagnosed incidentally during an eye examination. However, as mentioned in [2], some patients may complain of symptoms, although these are typically mild.

References:

• [10] Conjunctival concretions are small, typically multiple, yellow-white lesions commonly found on palpebral conjunctiva of elderly individuals and those with chronic inflammation.
• [11] To diagnose conjunctival concretions and assess their impact on ocular health, healthcare professionals may perform the following assessments: Eye examination: A comprehensive eye examination, including an evaluation of the conjunctiva, eyelids, and tear film, helps identify the presence of concretions and rule out other eye conditions.

Treatment Options for Conjunctival Concretions

Conjunctival concretions are typically asymptomatic and do not require treatment, but in some cases, medication may be prescribed to alleviate symptoms or prevent complications.

• Lubricating eye drops: Artificial tears or lubricating eye drops can help relieve dryness and discomfort associated with conjunctival concretions (6).
• Antibiotic ointment or drops: In rare cases where an infection is suspected, antibiotic ointment or drops may be prescribed to prevent or treat the infection (8).
• Fluconazole and itraconazole: In some instances, antifungal medications like fluconazole and itraconazole may be used to treat fungal infections that can cause conjunctival concretions (7).

Conservative Management

In many cases, conjunctival concretions are managed conservatively, meaning no treatment is necessary. This approach is often recommended when the concretions are asymptomatic and do not interfere with vision.

• Monitoring: Regular eye exams may be necessary to monitor the size and location of the concretions (10).
• No medication required: In most cases, no medication is needed to treat conjunctival concretions, as they are typically benign and asymptomatic (2, 12).

It's essential to note that treatment options for conjunctival concretions may vary depending on individual circumstances. If you have concerns about your eye health or suspect an infection, consult with an eye care professional for personalized advice.

References: [6] Oct 30, 2023 — Common treatment methods for conjunctival concretions include lubricating eye drops, artificial tears, and ointments. [7] by S Singh · 2023 — She was started on tablet fluconazole 150 mg once a week for 3 weeks along with 1% itraconazole eye ointment into the eye twice a day. [8] Afterwards you may need to use some antibiotic ointment or drops to settle the eye and prevent any infection. [10] Conjunctival concretions are small, typically multiple, yellow-white lesions commonly found on palpebral conjunctiva of elderly individuals and those with chronic inflammation. They are thought to be widespread and typically asymptomatic, occurring in 40-50% of studied populations. ... Treatment is usually unnecessary because the concretions ... [12] A conjunctival concretion is a benign entity characterized by single or multiple discrete yellowish-white deposits of varying size.

Differential Diagnosis of Conjunctival Concretions

Conjunctival concretions can be challenging to diagnose, as they may resemble other ocular conditions. To accurately diagnose conjunctival concretions, it is essential to differentiate them from the following entities:

• Epidermal inclusion cysts: These are benign growths that occur on the conjunctiva, often caused by a blockage of the gland ducts. They can be mistaken for conjunctival concretions due to their similar appearance.
• Lymphoid follicles: These are small, rounded collections of lymphocytes (white blood cells) that can form on the conjunctiva in response to inflammation or infection. Like epidermal inclusion cysts, they can be confused with conjunctival concretions.
• Conjunctival foreign body: A small object, such as a piece of metal or glass, can become embedded in the conjunctiva, leading to symptoms that may resemble those of conjunctival concretions. However, a conjunctival foreign body is typically associated with trauma and may be visible on the surface of the eye.
• Corneal foreign body: This condition involves a small object becoming lodged in the cornea (the clear dome-shaped surface at the front of the eye). It is often associated with trauma and can cause symptoms that may be mistaken for conjunctival concretions.

References:

• [2] Conjunctival concretion on inferior palpebral conjunctiva ... Differential diagnosis. Epidermal inclusion cysts; Lymphoid follicles ...
• [6] Differential Diagnosis. Three entities require differentiation from the conjunctival concretion: Conjunctival foreign body: if small and buried in the conjunctiva with a part protruding from the conjunctiva the foreign body may mimic a concretion; Epidermal inclusion cyst: can be congenital or acquired.
• [9] Sep 19, 2011 — Differential diagnosis. Corneal foreign body – usually associated with trauma, the foreign body may be seen on the cornea;
• [10] Conjunctival concretion on inferior palpebral conjunctiva. Diagnosis. Typically, patients are asymptomatic and the concretions are noted incidentally on ocular evaluation. ... Differential diagnosis. Epidermal inclusion cysts; Lymphoid follicles;