The lesion in case one is a benign retention or inclusion conjunctival cyst. The lesion in case 2 is a sebaceous cyst. The caruncle has hairs and the hairs have sebaceous glands associated with them. They can block off and cause a cyst the same way sebaceous cysts can occur on any other part of the skin. They are benign. Both cysts can be lanced at the slit lamp under topical anaesthetic. The cut must extend the length of the cyst and not be a simple stab in order to prevent recurrence. If there is a recurrence and it still has the appearances of a benign cyst, local anaesthetic can be used and the lesion excised in toto or de-roofed. If there is any suggestion that it is not benign, these lesions must be biopsied or excised completely and sent for histopathological examination.

In the two cases shown, the cysts were lanced under topical anaesthetic with a 27g needle. The first cyst contained clear fluid, the second, liquid sebaceous material. Topical Chlorsig was prescribed qid for 5 days. Neither of the cysts have recurred.