A dermolipoma is an epibulbar choristoma composed of adipose and dense connective tissue. Often, dermal tissue, including hairs, has replaced a portion of the overlying conjunctiva. Dermolipomas can be extensive, involving orbital tissue, the lacrimal gland, extraocular muscle, or a combination of these. Like limbal dermoids, dermolipomas can be associated with Goldenhar syndrome (see Chapter 18).
A, Epibulbar limbal dermoid with hair growing in the center. B, Corneal dermoid.
(Part A courtesy of Ken K. Nischal, MD; part B courtesy of Robert W. Hered, MD.)
Dermolipomas rarely require excision. If surgery is undertaken, the surgeon should attempt to remove only the portion of the lesion that is visible within the palpebral fissure, disturbing the conjunctiva and the Tenon layer as little as possible to minimize scarring and the risks of strabismus and dry eye. Cicatrization may occur even with a conservative operative approach.
Excerpted from BCSC 2020-2021 series: Section 10 - Glaucoma. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.