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

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