Congenital microphthalmos with orbital dermoid cyst extending to frontal sinus

A child presented with a chronic mucus discharging fistula from a mass over the right eyelid. There was a diagnostic dilemma about the mucus discharge from the mass which was probably thought to be secreted from the frontal sinus. The lesion caused a noticeable swelling in the eyelid with potential implications for surrounding structures. During surgical exploration, a large dermoid cyst was found occupying the entire orbit and extending into the frontal sinus, which was then thoroughly curetted and packed with fat to prevent recurrence and maintain structural integrity. On further exploration, a very rudimentary globe with a small optic nerve stump was discovered during the surgery, which was enucleated and socket reconstruction was performed with dermis-fat graft. The patient had a smooth postoperative recovery with good cosmetic results and no signs of recurrence or complications.