Right eye revealed an anechoic posterior chamber, yet the optic nerve was deviated owing to a hypoechoic mass localized medially and impinging upon the frontal bone with deviation of the bone. Minor periosteal reaction noted. The presumed tissue is uniformly hypoechoic. There is minor potential for abscess, yet no evidence of peri-lesional inflammation noted. If this were a lateral lesion, then zygomatic mucocele would be a possibility. However, given the medial position, neoplasia such as round cell neoplasia, adenocarcinoma or fibrosarcoma are all possible. Ultrasound guided FNA is recommended with oncology review or lobectomy with ancillary chemotherapy likely necessary. The left eye revealed a normal optic nerve position and uniform echogenic fatty tissue with anechoic posterior chamber.