Dermoid

Dermoid
SYMPTOMS Typically asymptomatic but could experience diplopia
SIGNS A smooth, painless mass that is typically superior temporal. If deeper in the orbit, it can cause a ptosis, EOM restriction, strabismus, and proptosis
WORK-UP Pupils, EOMs, Cover test, Ptosis evaluation, Exophthalmometry, Full eye exam
TREATMENT No treatment typically needed especially if patient is asymptomatic and/or dermoid is stable
Refer to an oculoplastic specialist or pediatric ophthalmologist for surgical removal of the dermoid if the patient is experiencing proptosis and/or diplopia, if the dermoid is growing in size, or if patients wants the dermoid removed for cosmetic reasons
FOLLOW-UP See patient back in 12 months in order to monitor dermoid
Once the dermoid is treated by an oculoplastic specialist/pediatric ophthalmologist and the eye is stable, the patient should be seen back in 6-12 months
ADDITIONAL LAB | TESTS Typically none but a CT or MRI of the orbit may be needed for dermoids that are deeper in the orbit
ETIOLOGY Congenital choristoma of the orbit
DIFFERENTIAL DX Lacrimal gland tumor, Mucocele, Dacryocele, Orbital tumor
NOTES None

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