Zaid Yousif Hameed Shukur
Epibulbar dermoids are the most common episcleral choristomas, these lesions may present unilaterally or bilaterally, and the majority (85%) are located in regions of the bulbar conjunctiva, limbus, cornea, and/or caruncles. An 11 months old male baby presented to my office by his parents, they were worry about a mass in his right eye. I examined the baby started to inspect his eyes by a torch then by the slit lamp biomicroscope and it revealed large elevated white pale mass with overlying hairs and slight yellow tinge on the surface of the mass, clinically it is a limbal dermoid on the inferotemporal aspect of the right globe. Congenital limbal dermoid in this case was according to surgical size and depth is regarded as grade II limbal dermoid, which in such case need for surgical excision because it cause high degree of astigmatism, the other indications include the effect on the visual axis, the dellen formation in adjacent corneal surface and also surgical indication for cosmetic purpose. In this case it caused high astigmatism with amblyopia in addition to the cosmetic effect on the patient's eye.
Keywords: Limbal dermoid; Dellen formation; Slit lamp; Anisometropic amblyopia
1. American Academy of Ophthalmology. Basic and Clinical Science Course. 2012. Series 6. American Academy of Ophthalmology.
2. Mansour AM, Barber JC, Reinecke RD, Wang FM. Ocular choristomas. Surv Ophthalmol 1989; 33:339-358. [PubMed]
3. Mohan M, Mukherjee G, Panda A. Clinical evaluation and surgical intervention of limbal dermoid. Indian J Ophthalmol 1981; 29: 69–73. [PubMed]
4. Nevares RL, Mulliken JB, Robb RM. Ocular dermoids. Plast Reconstr Surg 1988; 82:959–964. [PubMed]
5. Burillon C, Duran L. Solid dermoids of the limbus and the cornea. Ophthalmologica 1997; 211:367–372. [PubMed]
6. Mann I. Developmental Abnormalities of the Eye. Cambridge, UK: Cambridge University Press; 1937.
7. Mann I. Developmental Abnormalities of the Eye. In: Mann I, 2nd ed. Philadelphia, PA: Lippincott; 1957.
8. Amir Pirouzian Clinical Ophthalmology. Pirouzian, publisher and licensee Dove Medical Press Ltd, 2003.
9. Robb RM. Astigmatic refractive errors associated with limbal dermoids. J Pediatr Ophthalmol Strabismus 1996; 33:241-243. [PubMed]
10. Bourne RA. Epibulbar dermoid tumours of the corneal limbus treated by lamellar keratoplasty. Trans Can Opthalmolog Soc 1961; 24:153-158. [PubMed]
11. Zaidman GW, Johnson B, Brown SI. Corneal transplantation in an infant with corneal dermoid. Am J Ophthalmol 1982; 93:78-83. [PubMed]
12. Panton RW, Sugar J. Excision of limbal dermoids. Ophthalmic Surg 1991; 22:85–89. [PubMed]
13. Kaufman A, Medow N, Phillips R, Zaidman GJ. Treatment of epibulbar limbal dermoids. J Pediatr Ophthalmol Strabismus 1999; 36:136–140. [PubMed]
14. Lanzl IM, Augsburger JJ, Hertle RW, Rapauano C, Corea-Melling Z, Santa Cruz C. The role of ultrasound biomicroscopy in surgical planning for limbal dermoids. Cornea 1998; 17:604–606. [PubMed]
15. Hoops JP, Ludwig K, Boergen KP, Kampik A. Preoperative evaluation of limbal dermoids using high-resolution biomicroscopy. Graefes Arch Clin Exp Ophthalmol 2001; 239:459-461. [PubMed]
16. Grant CA, Azar D. Ultrasound biomicroscopy in the diagnosis and management of limbal dermoid. Am J Ophthalmol 1999; 128:365-367. [PubMed]
17. Scott JA, Tan DT. Therapeutic lamellar keratoplasty for limbal dermoids. Ophthalmology 2001; 108:1858-1867. [PubMed]
18. Shen YD, Chen WL, Wang IJ, Hou YC, Hu FR. Full-thickness central corneal grafts in lamellar keratoscleroplasty to treat limbal dermoids. Ophthalmology 2005; 112:1955. [PubMed]
19. Watts P, Michaeli-Cohen A, Abdolell M, Rootman D. Outcome of lamellar keratoplasty for limbal dermoids in children. J AAPOS 2002; 6:209–215. [PubMed]
20. Panda A, Ghose S, Khokhar S, Das HJ. Surgical outcomes of epibulbar dermoids. J Pediatr Ophthalmol Strabismus 2002; 39:20-25. [PubMed]
21. Mader TH, Stulting D. Technique for the removal of limbal dermoids. Cornea 1998; 17:66–67. [PubMed]
22. Pirouzian A, Holz H, Merrill K, Sudesh R, Karlen K. Surgical management of pediatric limbal dermoids with sutureless amniotic membrane transplantation and augmentation. J Pediatr Ophthalmol Strabismus 2012; 49:114–119. [PubMed]
23. Pirouzian A, Ly H, Holz H, Sudesh RS, Chuck RS. Fibrin-glue assisted multilayered amniotic membrane transplantation in surgical management of pediatric corneal limbal dermoid: a novel approach. Graefes Arch Clin Exp Ophthalmol 2011; 249:261-265. [PubMed]