A conjunctival concretion, also known as conjunctival lithiasis, is a common, small, yellowish-white deposit found on the inner surface of the eyelid, within the thin membrane called the conjunctiva. These deposits are generally benign and harmless, posing no serious threat to vision. They are frequently seen during a routine eye examination, often without the patient ever knowing they exist.
How Concretions Form and What They Contain
Concretions represent trapped cellular debris and compacted secretions within the palpebral conjunctiva, the lining on the inside of the eyelids. The formation process often begins when degenerated epithelial cells, mucus, and proteinaceous material, like keratin, accumulate in small depressions of the conjunctiva, sometimes near the meibomian glands. Over time, this debris can become compacted and may undergo calcification, leading to the small, hard, yellowish-white structures known as concretions.
This accumulation is often associated with the natural aging process and degenerative changes in the conjunctival tissue. Chronic inflammation is a significant contributing factor, increasing the risk of concretion development. Conditions like chronic dry eye syndrome, blepharitis, or recurrent conjunctivitis can lead to persistent irritation that triggers the buildup of cellular waste. The deposits typically remain embedded just beneath the surface layer of the conjunctiva.
Identifying the Presence of Concretions
Most conjunctival concretions are asymptomatic and are discovered incidentally during a comprehensive eye exam using a slit lamp, a specialized microscope for viewing the eye. Symptoms only arise when the concretion grows large enough or moves closer to the surface, causing it to rub against the cornea. When this happens, a patient may begin to experience noticeable discomfort.
Common symptoms include a persistent foreign body sensation, often described as a gritty or sandy feeling. The mechanical irritation from the protruding concretion can also lead to excessive tearing, redness, or generalized eye irritation. In rare cases, constant friction may cause a corneal abrasion, resulting in pain and blurred vision. Diagnosis occurs when a provider everts the eyelid to visually inspect the palpebral conjunctiva and confirm the presence of the lesions.
Clinical Treatment and Outlook
In cases where concretions are not causing any symptoms, active treatment is generally unnecessary, and the deposits are simply monitored. For symptomatic lesions that cause discomfort or irritation, removal is a straightforward, in-office procedure performed by an eye care professional. The process begins with the application of topical anesthetic drops to numb the surface of the eye and the eyelid.
The provider uses a fine needle or specialized instrument to carefully tease or lift the concretion out of the conjunctiva. This minor intervention offers immediate relief from the foreign body sensation and irritation. It is important to seek professional care for removal, as attempting to remove them oneself can cause serious damage or introduce infection. Recurrence is common, particularly if underlying chronic conditions like blepharitis or dry eye are not managed.