Cyst Excision and Globe Preservation in a Case of Microphthalmos With a Large Orbital Cyst and Visual Potential

Congenital microphthalmos belongs to a spectrum of diseases ranging from true anophthalmos to congenital clinical anophthalmos to microphthalmos. These conditions are frequently associated with an orbitopalpebral cyst, and pathologically, this represents a failure in the closure of the embryonic fissure at the 7–14 mm stage of gestation. The cyst develops as an outpouching from the eyeball and is generally helpful as it provides a stimulus for the orbit to expand. The general management guideline is to retain the cyst till it provides a stimulus for the orbit to expand and then to consider aspiration and sclerotherapy once orbital expansion is achieved. However, in eyes that have visual potential, sclerotherapy is contraindicated. The authors present an unusual case of a mildly microphthalmic eye with visual potential and a communicating cyst that was excised with a good result. The challenges faced in the excision of the communicating cyst with a wide pedicle and the management of the case are highlighted.