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My son had an orbital dermoid cyst. We noticed it around 9 months, but our concern was dismissed by our pediatrician. After we found another pediatrician, we had an ultrasound around 18 months that was inconclusive. An MRI at 20 months diagnosed it as a dermoid cyst. We were relieved by this diagnosis because they are almost always benign (not cancerous). The main concern with orbital dermoids are twofold: the most common concern is that it can rupture and cause a nasty periorbital cellulitis (skin infection around the eye), the other concern is that they could grow large enough to compress the optic nerve leading to blindness (very rare).

We were given two options- wait and see vs. surgery. We decided to proceed to surgery because the cyst had been increasing in size and we could see our son starting to rub at it more, so we knew it was bothering him. We choose not to go to the ophthalmologist in the health system in town (the one I actually work at) because I know they do maybe only one of these surgeries a year. I also happen to have a cousin who is an occuloplastics surgeon. She is an ophthalmologist who has gone on to further specialized in occuloplastics (a combination of plastic surgeon and eye stuff). She is amazing and is one of the top in her field. She is also a mother, so she understand the importance of these tiny people. She also does 10+ of these surgeries a month and does them at a children's hospital. It was a no brainer to go to her even though it was a 5 hour drive away. We scheduled his surgery for one week before his second birthday.

The surgery was a breeze. At the children's hospital they let us walk back with our son into the OR and hold him while they put him to sleep (this is rare, so don't expect it, my hospital does not do that). Then I went and got a coffee. Then a doughnut. Then he was done! We did find out that his cyst had ruptured at least once previously, but the surgeon was able to get it all out and no damage was caused by the rupture. We were able to drive home a few hours later. Aftercare was easy- just an antibiotic ointment over the incision three times a day for a week. He looked great the first day- just a tiny incision with stitches through the crease of his eye. The next day his whole eye was swollen shut and all black and blue, but it got better fast. The top layer of stitches dissolved pretty quickly.

We were supposed to have a follow up at 1 week, but since my dad is a optometrist, my cousin (the surgeon) let us "follow up" with him- it was mostly to verify there was no infection and that the wound hadn't opened up. We did go for a follow up with the surgeon at 6 weeks. We were a little worried at 5 weeks that the incision got a little redder, but she assured us that it was because she closed the incision in several layers and the redness was caused by the lower layers of stitches finally dissolving.

For a while he had a small raised scar in the crease of his eyelid that you couldn't see unless you were looking for it. We are two years out from his surgery and it is no longer raised. In fact, it is barely visible at all even if I'm looking for it. It is amazing how quickly children heal.

Obviously, I've been through this from start to finish, so if you have any other questions, I'd be happy to answer them

@emilye519: The pediatrician order the ultrasound and MRI prior to making the diagnosis.