Orbital conjunctival epithelial cyst mimicking cyst with microphthalmos

Orbitopalpebral cysts are most commonly associated with microphthalmic eyes (microphthalmos with cyst). We report a 15-year-old girl with a large orbitopalpebral cyst in the absence of associated microphthalmos. The patient presented with a massive swelling involving the left lower eyelid overhanging the left cheek and occupying much of the left orbital cavity. The globe was not visible on clinical examination. No history of trauma or surgery preceding the development of the cyst was reported by the patient or her father. Imaging showed a small eyeball displaced superiorly along the anterior part of the orbital roof. On excision of the cyst, a normal-sized globe with a cataractous lens was noted. Histopathological examination revealed the cyst to be of conjunctival origin.