Conjunctival Epithelial Inclusion Cyst in Pre- Existing Pterygium: A Case Report

Background: Pterygium is a common degenerative disorder of the ocular surface characterized by a fibrovascular growth extending from the bulbar conjunctiva onto the cornea, most commonly on the nasal side. Although typically benign, it may occasionally be associated with secondary epithelial and stromal changes. The occurrence of a conjunctival epithelial inclusion cyst within a pre-existing pterygium is rare. Aim: To report a rare case of a conjunctival epithelial inclusion cyst arising within a pterygium and to highlight its clinical significance. Case Presentation: A 69-year-old woman presented with a painless, translucent cystic swelling within a nasal pterygium of the left eye for six months. The lesion measured approximately 8 ? 3 mm, was freely mobile, and not adherent to the underlying sclera. There was no history of trauma, prior ocular surgery, or inflammation. Complete excision of the pterygium along with the cyst was performed, followed by conjunctival autografting. Histopathological examination showed stratified squamous epithelium with goblet cells, a fibrovascular stroma with congested blood vessels, and a cystic cavity lined by cuboidal to stratified epithelium, confirming a conjunctival epithelial inclusion cyst within pterygium. Clinical Significance: This rare association may mimic other cystic or neoplastic ocular surface lesions and can alter clinical assessment. Conclusion: Surgical excision with histopathological evaluation is both diagnostic and curative, and awareness of this entity is important in the differential diagnosis of cystic lesions in pterygium.