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Traumatic corneoscleral epithelial cyst

Published:August 19, 2021DOI:https://doi.org/10.1016/j.jcjo.2021.07.008
      Corneoscleral epithelial cyst is a rare clinical condition, which can be developmental or can follow ocular trauma. A 35-year-old male presented with painless progressive visual loss with gradually progressive corneal opacity in the left eye for more than 10 years. He had a history of trauma by stone particles while grinding before onset of the symptoms. He had no complaints in the other eye and not undergone any treatment for the pathology. His best-corrected visual acuity was counting fingers in his left eye and 20/20 in the right eye. Intraocular pressure was 12 mm Hg and 14 mm Hg in the right and left eye, respectively. Slit-lamp examination revealed an intrastromal corneal cyst involving middle and inferior portion of cornea obscuring the pupillary axis and extending into an intrascleral cyst inferiorly (Figure 1A and 1B). The cyst was renitent and immobile. The stroma outside the cyst margin was clear. Corneal vascularization or any signs of trauma was absent. Although difficult because of the corneal cyst, the rest of the anterior and posterior segment examination were normal. Anterior segment optical coherence tomography (AS-OCT) revealed the cyst cavity deep within the corneal stroma (Figure 1C), which was connected to the intrascleral cyst (Figure 1D). The patient had refused any surgical intervention.
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