Lang P J, Seitz B, Naumann G O
Augenklinik mit Poliklinik der Universität Erlangen-Nürnberg, Erlangen.
Klin Monbl Augenheilkd. 2004 Sep;221(9):776-80. doi: 10.1055/s-2004-813595.
Typically solid limbal dermoids are excised in pre-school age unless a high irregular astigmatism and its risk for amblyopia lead to an earlier intervention.
An 80-year-old lady from a rural area complained about a burning, tearing and foreign body sensation of the left eye for two months. In the past two years she had recognized that an extraocular prominence which had been present since birth had shown a tendency to grow. Slit lamp examination showed a markedly prominent and vascularized limbal tumor from 3.30 to 7.00 o'clock. Paralleling the border of the mass there was a bow-shaped stromal lipoid deposit reaching from limbus to limbus. Gonioscopic examination revealed a deep penetration of the process almost into the anterior chamber. The tumor was excised and some fatty tissue adjacent to Descemet's membrane was left. Histological assessment brought us to the diagnosis of a chronically irritated, predescemetal limbal dermoid with marked secondary vascularization, epidermalization, elastoid degeneration and degenerative arcus lipoides.
The excision of the limbal dermoid in the described case was performed in the later stage of life. When indicated cosmetically or medically, surgery should typically take place in pre-school age and be performed as a lamellar excision.