A 12-year-old boy presented with a greyish mesh over sclerae
of both eyes since birth and dimness of vision for last one
year that had worsened for a month. Ocular examination
revealed bilateral epibulbar limbal dermoids (Fig.
1) with astigmatism and amblyopia. There was no
microphthalmos, coloboma or strabismus.
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Fig. 1 Bilateral ocular (epibulbar)
dermoids.
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Ocular dermoids – common primary
developmental orbital tumours – are smooth, soft and
yellowish subconjunctival masses, most commonly at the
inferotemporal limbus. Occasionally the lesions may be very
large and virtually encircle the limbus (complex dermoid).
Sometimes these may be associated with accessory auricles
and syndromes (Goldenhar syndrome, Treacher collins
syndrome, etc.). Differential diagnosis include
dermolipoma or fibrofatty tumour.
Surgery may be required for cosmetic
reasons, chronic irritation, dellen formation, amblyopia or
involvement of the visual axis.