Limbal dermoids rank among the most common tumors of the corneal limbus. They are ocular choristomas and can occur in a variety of sizes. Images in Clinical Medicine from The New England Journal of Medicine — Limbal Dermoid. Images in Clinical Medicine from The New England Journal of Medicine — The Hairy Eyeball — Limbal Dermoid.

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Left eye slit lamp view shows the elevated, fatty appearance of this limbal dermoid. Long-term results of allogenic penetrating limbo-keratoplasty in total limbal stem cell deficiency. Grade II limbal dermoids are of larger size and extend into the corneal stroma down to Descemet’s membrane.

Eye Ear Nose Throat Mon. Major risks of the excision of the limbal dermoid are intraoperative perforation, postoperative epithelial defects and peripheral vascularization of the cornea.

Right eye 2 years after removal of large limbal dermoid see Figure 1. Temporary signs of ischemia after treatment with Mitomycin C Figure 2b linbal completely and did not pose any further complications.

Grade I limbal dermoids are superficial lesions measuring less than 5 mm and are localized to the limbus Figure 1. The induced astigmatism from this dermoid is small and readily corrected with spectacles. Trans Can Opthalmolog Soc. Shen et al, in their retrospective Taiwanese study of 10 patients aged 5.

The graft remained transparent without complication or rejection, and the drrmoid continued to maintain constant fixation initially. Conservative management by observation may not be deroid suitable option for such lesions. Electrocardiogram EKG and chest x-ray derrmoid within normal limits for age. These authors considered that this technique minimized the complications associated with large corneal transplants and increased the chance of long-term success.


Dermoid excision and lamellar keratoplasty was performed in 48 eyes, simple excision was performed in two eyes, and a penetrating graft was performed in one eye. Received May 13; Accepted Apr Mean visual acuity was 0.

Management of pediatric corneal limbal dermoids

Eur J Med Genet. Additional amniotic membrane transplantation.

InBourne treated a series of four pediatric patients with grade II limbal dermoid by direct excision followed by lamellar keratoplasty using a 5—7 mm trephine with a good outcome. Solid corneal dermoids and subconjunctival lipodermoids: Amniotic membrane transplantation in ophthalmology fresh v preserved tissue Br J Ophthalmol. The geneticist noted very subtle hemifacial microsomia, with the right side of the patient’s face being slightly smaller than the left.

A new syndrome of autosomal dominantly inherited, bilateral, annual limbal dermoids with corneal and conjunctival extension. As was the case with this child, Goldenhar syndrome is generally believed to be a spontaneous malformation in utero, without a predictable inheritance pattern.

Goldenhar Syndrome (Oculo-Auriculo-Vertebral Spectrum):

Cambridge University Press; The patient was followed closely in our clinic during this time. They can be autosomal dominant, recessive, X-linked, or multifactorial. Autologous human fibrin glue in multilayered amniotic membrane transplantation.

Amniotic membrane use in ophthalmology. Genetics and inheritance The pattern of inheritance is quite variable in epibulbar choristomas.

One of these cases developed graft infection, underwent subsequent debridement, and had an opaque graft. Depth, size, and site of such lesions are critical factors. Our reason for using amniotic membrane was to achieve a reduction of postoperative inflammation and scarring. No eye treated with Mitomycin C developed a postoperative pseudopterygium Figure 4. They are marginally vascularized, smooth, whitish lesions with sebaceous components generally located in the inferotemporal globe or temporal limbus.


Shortly after delivery, he was noted to have bilateral “fleshy masses” on the corneas and an irregular right upper eyelid.

Although indepth management of grade III limbal dermoids have been described in the literature, the surgical management of grade I and II limbal dermoids llimbal to evolve as a result of developing technology.

Solid dermoids lombal the limbus and the cornea. Chan SM, Boisjoly H. Multilayered amniotic membrane transplantation for severe ulceration of the cornea and sclera. However, the depth of the dermoid could not be definitely measured with this technique. Surgical complications included prolonged re-epithelialization, interface neovascularization, graft rejection, and steroid-induced glaucoma.

Current standard medical treatment for grade I pediatric limbal dermoids ie, with superficial corneal involvment is initially conservative.

Management of pediatric corneal limbal dermoids

Conjunctival epithelial cell xermoid on amniotic membrane. Excision of limbal dermoids. Enucleation or evisceration with subsequent orbital reconstruction has been proposed for grade III limbal dermoids where dermoi globe is microphthalmic. No pallor or edema of either disc. Other techniques include corneal-limbal scleral donor graft transplantation and surgical resection followed by reconstructive sutureless multilayered amniotic membrane transplantation. Notes The authors declare no conflict of interest.

This may lead to irreversible anisometropic amblyopia in children.