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Congenital orbital cyst

Photo by Professor Chua Chung Nen

A 2-week old baby was referred because of a cystic swelling of the left interior orbit causing problem with eye opening. A CT scan performed by the paediatrician revealed an inferior fluid-filled orbital mass and a microphthalmic globe. There was no evidence of connection between the vitreous cavity and the mass. A subciliary approach was performed, the wall of the cyst was excised to prevent reaccumulation of any fluids. Ocular examination did not show any signs of coloboma. The patient was able to open the left eye 24 hours post-operative but there was an enophthalmos due to the microphthalmos.

 

Left inferior orbital cyst.   CT scan showing the cystic lesion extending to the back of the globe.   CT scan showing microphthalmos and an inferior orbital mass.   Subciliary approach to the lesion.   Cystic lesion with blood-stained fluid.   The wall of the cyst was excised after draining the fluid.   24 hours post-operative.

Atlas of Paediatric Ophthalmology