Dermoid, Limbal Treatment & Management

  • Author: Mark D Sherman, MD; Chief Editor: Hampton Roy Sr, MD   more...
 
Updated: Feb 17, 2010
 

Surgical Care

  • Treatment of limbal dermoids may consist of periodic removal of irritating cilia, topical lubrication to prevent foreign body sensation, or excision of the lesion if it is causing significant cosmetic disfigurement or interfering with vision.
  • Surgical treatment should be instituted only when the risk of subsequent scar formation or surgical complications are outweighed by the likelihood of improving the patient's vision or cosmetic appearance.
  • A superficial sclerokeratectomy, cutting flush with the surface of the globe, is the procedure of choice for removal of the dermoid. Excised tissue always should be sent to the pathologist for examination.
  • Attempts at complete removal are unnecessary. The lesion may extend into the deeper structures of the eye and the risk of perforation increases if attempts are made to remove the lesion completely.
  • The exposed sclera should be covered by relaxing the adjacent conjunctiva and sewing it into the scleral defect. If a deep excision is necessary, then a lamellar keratoplasty can be performed to reinforce the site of excision.
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Consultations

  • Obtaining a thorough family and medical history helps determine whether further consultation is necessary.
  • In some cases, referral to a pediatrician with specialization in genetics is appropriate.
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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  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.

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

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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