Note this case contains graphic images from surgery.

Chief Concern: This 45 year man (Figure 1) reports that over a period of years he has noticed a gradual swelling the right inner corner of his eyelids with a progressive bulging and displacement of the eye. He is now seeking care because the process seems to be affecting his vision.
Figure 1

Diagnosis: A CT scan (Figure 2) demonstrates a large mass in the right orbit responsible for the displacement of the eye. The mass is located next to the sinus and is consistent with a sinus mucocele, which is cyst that is lined by the same surface that lines the sinus. This likely got its start after a sinus infection in the past.
Figure 2

Treatment: Surgery is necessary to address this problem. The key is not just draining the cyst, but actually removing the wall of the structure so it does not reform. Surgery is performed under general anesthesia. The incision is marked on the skin (Figure 3).
Figure 3

The lesion is exposed and to facilitate remove of the sac, a small hole is made into the sac and the contents drained (Figure 4).
Figure 4

The cyst wall is then dissected free from the orbit (Figure 5). The incision is then closed and the patient is observed overnight before discharge.
Figure 5

Here is the cyst (Figure 6) once it was removed. Note that it is almost 2 inches in length. Following surgery, the eye returned to its normal position and the patient experienced significant improvement of his vision.
Figure 6