Traumatic corneal cyst.

A 23-year-old male presented with defective vision in right eye ‘oculus dexter’ (OD) following trauma with iron rod 9 years ago. The visual acuity in OD was 20/30. A 6 × 4 mm intrastromal cyst was seen in the inferior paracentral cornea with white fluid [Fig. 1a]. OS, (oculus sinister) was normal. In AS OCT, the cyst was localized in the posterior stroma, with a distinct fluid level [Fig. 1c]. Drainage of the cyst was done through a peripheral stab incision and the histopathology examination revealed degenerative material with keratinocytes. Chemical cauterization was avoided due to the proximity of the lesion to endothelium. The visual acuity in OD improved to 20/20 with collapsed cyst and minimal stromal scarring [Fig. 1b]. There were no signs of recurrence of fluid collection at the final follow up visit at 3 months. Intracorneal cysts are a sequestration of epithelial cells in the mid to deep corneal stroma often following a penetrating trauma.[1] As simple drainage of the cyst have been associated with recurrence of the fluid accumulation, chemical cauterization with distilled water, 5-fluorouracil, ethanol and trichloroacetic acid have been utilized to prevent recurrence in mid stromal cysts.[23] OCT-guided chemical cauterization and penetrating keratoplasty are the treatment options for recurrent deep stromal visually significant intracorneal cysts.[4]

Figure 1

(a) Corneal Intrastromal cyst with fluid level. (b) 1 month after cyst drainage. (c) AS OCT image of posterior stromal corneal cyst with fluid level (Arrow head)

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