Where else in the body can you find dermoid cysts?

Imagine a crown, that sits around the head. Dermoid cysts are most commonly found in the region that circulates the skull, on an imaginary line at the level of the eyes.
But in this chapter, we will focus on dermoid cysts found around the eyes, the two different types.

Orbital dermoid

Where are orbital dermoids found?

They are usually found near the bones that are around the eye. Usually in the area where the bones connect to form the orbit of the eye. The most common area to find dermoid cysts is the upper – outer region of the orbit, near the eyebrow. Dermoids can also develops closer to the bridge of the nose.

How are orbital dermoids diagnosed?

Just like other conditions in medicine, we start by asking the parents questions (when they first noticed the lesion, how fast has it been growing) and clinical findings (the location, palpation and more). Sometimes, imagine is required, such as an ultrasound or MRI to confirm the diagnosis or to assess the size of the lesion and its extension into the orbit.

Do orbital dermoids need to be removed?

Since these dermoids can tear and spill their contents into the eye, leading to an inflammatory reaction, pediatric ophthalmologists often recommend removing the dermoids that develop around eyes.

How can orbital dermoids be removed?

This is a procedure performed under general anesthesia, in an operating room, under sterile conditions. The skin above the dermoid is incised, the tissues on top of it are separated until the dermoid is exposed. It is removed gently from its surroundings until the entire thing is out. The lesion is sent to pathology to confirm the clinical diagnosis.

Are orbital dermoids associated with any other conditions or diseases?

No.

Limbal dermoids

Where are limbal dermoids found?

As you saw in the second image attached, limbal dermoids are found on the surface of the eye – the cornea, or at the border between the cornea and the sclera.

Do limbal dermoids need to be removed?

Limbal demroids can be removed to improve the way the eye looks, reduce the pressure it exerts on the cornea and reduce the irritation it may cause to the eye.

How are limbal demroids removed?

A surgeon (pediatric ophthalmologist or cornea specialist) will separate the limbal dermoid from the surface of the cornea and the sclera, in the operating room, under general anesthesia. Sometimes, after removal of the limbal dermoid, and depending on the decision of the surgeon, the resected area is covered by a piece of cornea from a donor or with a special membrane.

Can limbal dermoids lead to loss of vision?

Sometimes, limbal demroids can be so big that they obstruct the visual axis and prevent the eye from vision. Nonetheless, more often than not, the deterioration in vision occurs because of the pressure that the limbal dermoid that exerts on the cornea and the distortion it causes which leads to significant astigmatism and blurry vision. If the condition is left untreated, the blurry vision from the eye can lead to a lazy eye and cause irreversible damage to vision. Fortunately, if this lazy eye is detected early enough during childhood, it can be successfully treated, as you will learn in the following link.

Are limbal dermoids associated with other conditions?

Sometimes they are. Limbal dermoids can be found in people with different syndromes, the most common of which is Goldenhar syndrome.

In summary, dermoid cysts in babies are quite common in the pediatric clinic. When the lesion is found near your child’s eye, as we’ve learnt in the post above, it should be assessed by a specialist in the field so that it can be promptly diagnosed and the best treatment available can be offered to your child.

Good luck.