September 1988

Radiological Case of the Month

Author Affiliations

From the Departments of Ophthalmology and Pediatrics (Dr Baker) and Diagnostic Radiology (Dr Goldstein), Albert B. Chandler Medical Center, University of Kentucky, Lexington.

Am J Dis Child. 1988;142(9):979-980. doi:10.1001/archpedi.1988.02150090077027

A 15-year-old girl was examined for right-sided ocular proptosis that had been gradually progressive over a one-year period. Her right eye bulged approximately 0.5 cm and was oriented medially and slightly downward. She had no pain or tenderness. Visual acuity was 20/20 OU and visual fields were full, with no diplopia in any field of gaze. Results of neurologic and physical examinations were normal.

The orbits were examined by complex motion tomography (Fig 1) and computed tomography (Fig 2). The right orbit was surgically explored through a lateral approach.

Denouement and Discussion 

Epidermoid Cyst of the Orbit  A gray, cystic mass was found on surgical exploration of the right orbit via a lateral approach, without excision of bone. The lesion, limited by periosteum below and dura above, was totally removed by stripping it away from surrounding tissues. Postoperatively, right-sided ocular proptosis resolved.

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