In a bedridden, medically fragile patient with a symptomatic conjunctival cyst superior to the limbus, what is the optimal management approach?

I would first attempt medical management with lubricants, ketorolac, olopatadine, and naphazoline.

If those failed, then I would use the following drops: topical anesthetic, a vasoconstrictor, and ketorolac twice over a five-minute period, then insert a lid speculum, and unroof the cyst by grasping the top of the cyst, lifting it up, and snipping it off with one or two snips.

I would then repeat the vasoconstrictor and ketorolac, followed by an antibiotic salve like erythromycin.

There is a reasonably good chance it will not recur or be smaller when it recurs.