Limbal Dermoid Clinical Presentation

  • Author: Mark D Sherman, MD; Chief Editor: Hampton Roy Sr, MD   more...
 
Updated: Apr 17, 2012
 

History

  • Patients present with decreased vision or poor vision, foreign body sensation, cosmetic disfigurement, or an enlarging ocular mass.
  • Most patients present before age 16 years.
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Physical

  • Most epibulbar dermoids are located at the inferior temporal limbus.
  • Rarely, they may only affect the cornea or the bulbar conjunctiva.
  • Epibulbar dermoids have a dome shape, and the surface may appear keratinized.
  • Hair follicles and cilia may be visible.
  • The dermoid appears fleshy and may have fine superficial vascularization.
  • Associated ocular abnormalities include colobomata of the eyelids, Duane retraction syndrome and other ocular motility disorders, lacrimal anomalies, scleral and corneal staphylomata, aniridia, and microphthalmia.
  • Associated systemic abnormalities include preauricular appendages and auricular fistulae (in combination with limbal dermoids constituting Goldenhar syndrome). Other abnormalities include hemifacial microsomia, microtia, and vertebral anomalies.
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Causes

  • Most cases of limbal dermoids are sporadic and not related to any known toxic exposure or mechanical irritant.
  • Instances are reported of epibulbar dermoids being related to maternal ingestion of teratogenic agents during the first trimester of development.
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Contributor Information and Disclosures
Author

Mark D Sherman, MD  Assistant Clinical Professor, Department of Ophthalmology, Loma Linda University School of Medicine; Private Practice, Pacific Eye Surgeons

Mark D Sherman, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery, and American Uveitis Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Andrew W Lawton, MD  Medical Director of Neuro-Ophthalmology Service, Section of Ophthalmology, Baptist Eye Center, Baptist Health Medical Center

Andrew W Lawton, MD is a member of the following medical societies: American Academy of Ophthalmology, Arkansas Medical Society, and Southern Medical Association

Disclosure: Nothing to disclose.

Simon K Law, MD, PharmD  Associate Professor of Ophthalmology, Jules Stein Eye Institute, University of California, Los Angeles, David Geffen School of Medicine

Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, and Association for Research in Vision and Ophthalmology

Disclosure: Nothing to disclose.

J James Rowsey, MD  Former Director of Corneal Services, St Luke's Cataract and Laser Institute

J James Rowsey, MD is a member of the following medical societies: American Academy of Ophthalmology, American Association for the Advancement of Science, American Medical Association, Association for Research in Vision and Ophthalmology, Florida Medical Association, Pan-American Association of Ophthalmology, Sigma Xi, and Southern Medical Association

Disclosure: Nothing to disclose.

Lance L Brown, OD, MD  Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri

Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD  Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences

Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

References

  1. Henkind P, Marinoff G, Manas A, Friedman A. Bilateral corneal dermoids. Am J Ophthalmol. Dec 1973;76(6):972-7. [Medline].

  2. Mann I. Developmental Abnormalities of the Eye. 1957:357-364.

  3. Duke-Elder S. System of Ophthalmology: Congenital and Developmental Anomalies. Vol 3. 1963:488-495.

  4. Yanoff M, Fine B. Ocular Pathology. 1982:316-317.

  5. Baum JL, Feingold M. Ocular aspects of Goldenhar's syndrome. Am J Ophthalmol. Feb 1973;75(2):250-7. [Medline].

  6. Mansour AM, Barber JC, Reinecke RD, Wang FM. Ocular choristomas. Surv Ophthalmol. Mar-Apr 1989;33(5):339-58. [Medline].

 
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Limbal dermoid in the left eye of a 13-year-old male patient.
Histopathological section demonstrating a pilosebaceous unit.
 
 
 
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