A tiny yellow-white spot on the inside of an eyelid can cause a surprisingly persistent scratchy feeling. This may be a conjunctival concretion – a small deposit that is usually harmless but can become very uncomfortable when it rubs against the surface of the eye. If your eye feels as though there is grit trapped in it, a thorough eye examination can identify the cause and provide the right care.
What is a conjunctival concretion?
A conjunctival concretion is a small, firm deposit that forms beneath the conjunctiva, the clear tissue lining the inside of the eyelids and covering the white of the eye. It is made up of material such as calcium, protein and shed cells. Concretions often look like tiny pale yellow or white dots when the lower or upper lid is gently turned out during an examination.
They are common in adults, particularly when there has been long-term irritation or inflammation around the eyelids. Many people have more than one concretion and never know they are there. When a deposit remains covered by the conjunctiva, it often causes no symptoms at all.
A concretion is not the same as a foreign body, such as dust or metal, that has entered the eye from outside. It is also different from conjunctivitis, commonly called pink eye. Concretions are not contagious, although the eyelid inflammation that contributes to them may need attention.
Why conjunctival concretions develop
Concretions can develop when the conjunctiva has been irritated over time. They are often associated with blepharitis, which is inflammation along the eyelid margins, and meibomian gland dysfunction, where the tiny oil glands in the lids are not working as well as they should. Both conditions can contribute to dry, irritated eyes.
Other contributing factors can include long-standing dry eye, allergies that lead to frequent rubbing, past eye infections or chronic conjunctival inflammation. As we get older, these deposits may become more likely. However, having a conjunctival concretion does not necessarily mean there is a serious underlying eye disease.
The key is to look at the whole picture. A patient with occasional, symptom-free concretions may not need treatment. Someone with recurring deposits, burning eyes, flaky eyelids or frequent redness may benefit from a dry eye and eyelid assessment to address the irritation behind the problem.
Symptoms to watch for
A buried concretion is often found incidentally during a routine eye test. Symptoms tend to begin when the deposit works its way through the conjunctiva and becomes exposed. Each blink can then make it rub against the eye’s surface.
You may notice a gritty or scratchy sensation, watering, localised redness, mild discomfort or the feeling that something is in your eye. Some people find their symptoms are worse later in the day, when their eyes are already dry or tired. Contact lens wear can also become less comfortable.
A sharp concretion can occasionally scratch the cornea, the clear front window of the eye. This can cause more significant pain, light sensitivity, blurred vision or a strong urge to keep the eye closed. These symptoms need prompt assessment rather than home treatment.
When an eye problem needs urgent care
Not every red or uncomfortable eye is caused by a conjunctival concretion. Seek urgent eye care if you have sudden vision loss, severe pain, marked light sensitivity, a chemical splash, an injury to the eye, or redness with nausea and headache. If you wear contact lenses and develop a painful red eye, remove the lenses and arrange an urgent assessment.
A concretion may be uncomfortable, but severe symptoms can point to a corneal abrasion, infection or another condition that needs timely treatment. Trying to work out the cause by looking closely in a mirror is not a substitute for an examination.
How a conjunctival concretion is diagnosed
An optometrist can usually identify a concretion during a close examination with a slit lamp microscope. The eyelids may be gently everted so the inside lining can be checked properly. This is quick and should not be painful.
Your optometrist may also use a fluorescein dye to check whether the cornea has been scratched. The examination includes looking for dry eye, blocked eyelid oil glands, blepharitis and signs of allergy or inflammation. This matters because simply removing an exposed deposit may relieve the immediate irritation, but managing the contributing eyelid condition can reduce future discomfort.
Treatment for an exposed concretion
If a concretion is buried and not causing symptoms, it is generally best left alone and monitored as part of regular eye care. Removal is usually considered only when it is exposed or clearly causing irritation.
In clinic, the eye is numbed with anaesthetic drops. The optometrist can then carefully remove the exposed deposit using a fine sterile instrument under magnification. The procedure is usually brief. You may feel a little awareness of the eyelid being held, but you should not feel sharp pain.
After removal, lubricating eye drops may be recommended while the surface settles. If there is an abrasion or notable inflammation, your optometrist will advise on the most appropriate treatment and follow-up. In some cases, particularly if the finding is unusual or there are other eye health concerns, referral to an ophthalmologist may be recommended.
Do not try to remove a suspected concretion yourself. Fingernails, tweezers, tissues and cotton buds can scratch the cornea, introduce infection or push the deposit further into sensitive tissue. Rinsing the eye may help with loose dust, but it will not remove a concretion that is embedded in the eyelid lining.
Reducing irritation and recurrence
There is no guaranteed way to prevent every concretion, but consistent eyelid and dry eye care can make a meaningful difference for people prone to irritation. The right approach depends on what is driving the inflammation.
For blepharitis or meibomian gland dysfunction, a clinician may recommend warm compresses and careful lid hygiene. Preservative-free lubricating drops can help when dry eye is contributing to friction and discomfort. Allergy management may be useful where itching and rubbing are a regular issue. More persistent dry eye may need targeted treatment after a detailed assessment, rather than relying on whatever drops are available at the chemist.
Avoid rubbing your eyes, even when they itch. Rubbing can aggravate the eyelid lining and may worsen redness or irritation. If you use contact lenses, follow the recommended wearing schedule and do not wear them through ongoing discomfort or a red eye.
When to book an eye examination
Book an appointment if you have a recurring foreign-body sensation, unexplained watering, a scratchy eye that does not settle, or a visible pale spot inside your eyelid. It is particularly worthwhile if symptoms keep returning after using lubricating drops, or if dry eye and eyelid irritation are affecting your comfort at work, school or while driving.
At Boda Family Eye Care, a comprehensive assessment can check for conjunctival concretions as well as the dry eye, eyelid or surface concerns that may be contributing to your symptoms. Eligible patients may be able to claim a Medicare rebate for an optometry consultation, while any recommended treatment will be explained clearly before proceeding.
A small eyelid deposit is rarely a reason to panic, but you do not need to put up with the constant feeling that something is caught in your eye. A careful examination can bring clarity, relief and a practical plan for keeping your eyes more comfortable.