DR. SUNITHA M KURIAKOSE

DR. K.S. SIDDHARTHAN

Abstract

60 year old male with no trauma history, presented with slowly progressing painless whitish lesion in cornea of a pseudophakic eye of 1 year duration. Right cornea showed whitish midstromal cystic swelling from centre of cornea to infero-temporal limbus simulating a hypopyon. DIAGNOSIS: Rare adult intrastromal corneal epithelial cyst made.Vision reduced from 6/18 to 6/60 in 6 months as lesion expanded towards pupillary area with a maximum diameter of 7mm.TREATMENT:Due to progression in size, vision deterioration, unresponsiveness to medical management and reported recurrence in drainage procedures, total excision with penetrating keratoplasty was done.Vision improved to 6/12 post-op with no recurrence.DISCUSSION:Intraepithelial corneal cysts are rare, congenital/post trauma due to displaced epithelial cells into stroma with cyst cavity lined by limbal epithelium.It simulates hypopyon on standing as cystic contents settle to bottom.Total surgical excision is only definitive management.