Grand Rounds
  Most Recent Cases
  Dates of Case
  Type of Case
  Submit a Grand Round.
  Register with DJO to receive personalized updates.

If you're already a
member, please sign in.
A 64-year-old man with an unusual conjunctival cyst
Digital Journal of Ophthalmology 2017
Volume 23, Number 1
March 8, 2017
DOI: 10.5693/djo.03.2016.04.001
Printer Friendly

Download PDF



Seanna Grob, MD, MAS | Department of Ophthalmology, Veterans Affairs Boston Healthcare System, Boston, Massachusetts Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts Department of Ophthalmology, Massachusetts Eye and Ear Infirmary
Daniel R. Lefebvre, MD | Department of Ophthalmology, Veterans Affairs Boston Healthcare System, Boston, Massachusetts Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts Department of Ophthalmology, Massachusetts Eye and Ear Infirmary Ophthalmic Plastic Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts
Nora Laver, MD | Ophthalmic Pathology, Department of Ophthalmology, Tufts Medical Center and Tufts University School of Medicine, Massachusetts
Mary K. Daly, MD | Department of Ophthalmology, Veterans Affairs Boston Healthcare System, Boston, Massachusetts Department of Ophthalmology, Boston University School of Medicine, Boston, Massachusetts Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
Ancillary Testing
Cataract surgery was deferred, and the patient underwent excision of the medial canthus conjunctival cyst for diagnostic purposes.

Histopathological Analysis
Paraffin-embedded, formalin-fixed tissue slides showed a chronically inflamed conjunctival cyst. (Figure 2). Cross-sections of the cyst revealed a degenerating nematode (Figure 2A-C). Sections through the degenerating nematode showed smooth, refractile cuticles, internal lateral ridges, and a suggestion of degenerated internal organs (Figure 2). Pathology images were sent to the Center of Disease Control (CDC), which confirmed the specimen was a nematode but was unable to prove any further classification.
top
Figure 2
Histopathological analysis (hematoxylin and eosin, original magnification ×4): subconjunctival cyst (black arrow), with degenerating nematode particles (black asterisk). Inset left, higher magnification of the degenerating nematode (×20). Inset right, higher magnification (×40) of the degenerating nematode, with smooth, refractile cuticles (black arrow), internal lateral ridges (red asterisk), and a suggestion of degenerated internal organs (yellow asterisk).