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Dermoid, Limbal: Differential Diagnoses & Workup

Author: Mark D Sherman, MD, Assistant Clinical Professor of Ophthalmology, Loma Linda University School of Medicine; Private Practice, Central Coast Eye Associates
Contributor Information and Disclosures

Updated: Aug 2, 2007

Differential Diagnoses

Juvenile Xanthogranuloma
Peters Anomaly

Other Problems to Be Considered

Foreign body granuloma
Sclerocornea
Staphyloma
Corneal scar (from trauma or infection)
Hemangioma
Atypical pterygium

An estimated 30% of patients with dermoid choristomas have associated systemic abnormalities, including Goldenhar syndrome, nevus flammeus, and neurofibromatosis.

Other systemic disorders reported include cardiovascular abnormalities, vertebral anomalies, and auricular defects.

Workup

Laboratory Studies

  • The diagnosis of a limbal dermoid requires a directed clinical examination. Specific laboratory studies are generally not necessary.

Imaging Studies

  • MRI
    • Some dermoids may appear to extend into the conjunctival fornix or lateral canthus. These lesions may contain connective tissue that entangles with the orbital fat and muscle tissue belonging to the extraocular muscles.
    • Radiologic imaging with an MRI can be useful in identifying such lesions, especially if surgical management is being considered.

Procedures

  • Biopsy is not necessary, except in rare instances when the diagnosis is doubtful.

Histologic Findings

Limbal dermoids contain choristomatous tissue, including epidermal appendages, adipose and lachrymal gland tissue, smooth and striated muscle, cartilage, brain, teeth, and bone. Lymphoid nodules and vascular elements also have been reported. The surface of the dermoids consists of corneal or conjunctival epithelium. The lesion may be cystic or solid.

More on Dermoid, Limbal

Overview: Dermoid, Limbal
Differential Diagnoses & Workup: Dermoid, Limbal
Treatment & Medication: Dermoid, Limbal
Follow-up: Dermoid, Limbal
Multimedia: Dermoid, Limbal
References
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References

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

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

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

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

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

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

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Further Reading

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Keywords

dermoid, dermoid choristoma, dermoid cyst, epibulbar dermoid, epibulbar choristoma, corneal dermoid

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Contributor Information and Disclosures

Author

Mark D Sherman, MD, Assistant Clinical Professor of Ophthalmology, Loma Linda University School of Medicine; Private Practice, Central Coast Eye Associates
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.

Medical Editor

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.

Pharmacy Editor

Simon K Law, MD, PharmD, Assistant Professor of Ophthalmology, Jules Stein Eye Institute; Chief of Section of Ophthalmology Surgical Services, Department of Veterans Affairs Healthcare Center, West Los Angeles
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.

Managing Editor

J James Rowsey, MD, Director of Corneal Services, St Luke's Cataract and Laser Institute, Florida
Disclosure: Nothing to disclose.

CME Editor

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.

 
 
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