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Resident PGY 2
Henry Ford Hospital
Background: Dermoid cysts are one of the most common orbital lesions in childhood. They typically present as a palpable subcutaneous mass in the superotemporal region along the frontozygomatic suture. When involving the eye, ocular dermoids typically present as visible lesions at the limbus.
Clinical Case Report: A five-year-old male presented with focal injection of the left nasal conjunctiva sparing the limbus that progressed to a non-mobile scleral nodule with overlying 3+ injection, tenderness to palpation, and minimal blanching with phenylephrine suspicious for nodular scleritis versus abscess. The inflammation improved, but the nodule persisted despite treatment with topical antibiotics, steroids, and oral NSAIDs. Superonasal subconjunctival excisional biopsy revealed an 8mm mass with a visible hair protruding from lesion, with pathological analysis revealing findings of acutely inflamed dermoid cyst.
Discussion: To our knowledge, this is the first documented case of a non-limbal ocular dermoid masquerading as nodular scleritis.
Hamid, Mariam; Steen, Daniel W.; Ormsby, Adrian H.; and Le, Kim, "Inflamed Non-Limbal Scleral Dermoid Masquerading as Nodular Scleritis" (2020). Case Reports. 86.