Pearl cysts are commonly seen after penetrating trauma and represent an inflammatory response of the vascular iris tissue, when exposed to external epithelial cells introduced into the eye after trauma or surgery, leading to a cystic or pearly appearance [1]. These are usually located in the anterior chamber, emerging from the iris. Intracorneal cysts have also been reported [2]. Trauma in our patient might have led to a corneal perforation which was plugged by the iris tissue, hence leading to external proliferation and pearl cyst formation outside the eye, through the site of perforation. Such an external iris pearl cyst has been rarely reported [3]. We offered an excision to improve the cosmetic appearance of the eye, which the parents of the child wanted to defer.

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