A dermolipoma is a non-cancerous growth that can appear on the surface of the eye.
What is a Dermolipoma?
A dermolipoma is a benign growth, typically present from birth, composed of fatty tissue and skin-like elements. These growths are classified as choristomas, meaning they are made of normal tissue found in an abnormal location. They commonly appear as a yellowish or pale, yellow-pink, soft mass, often covered by the conjunctiva, the clear membrane that covers the white part of the eye.
The most frequent location for a dermolipoma is in the outer corner of the eye, near the bulbar conjunctiva. While they are usually unilateral, affecting only one eye, they can occasionally occur in both eyes. These growths develop slowly and do not affect adjacent ocular structures or cause significant vision problems.
Dermolipomas are asymptomatic, meaning they do not cause discomfort or pain. The exact cause of dermolipoma is not fully understood, but it is believed to be a congenital abnormality resulting from changes during fetal development where fat tissue migrates to the conjunctiva. Dermolipomas may be associated with other congenital anomalies, such as those seen in Goldenhar syndrome.
Identifying and Diagnosing Dermolipoma
Dermolipomas are often discovered incidentally during a routine eye examination, as they frequently do not cause noticeable symptoms. When symptoms do occur, they are mild and might include a sensation of a foreign body, slight irritation, or redness of the eye. Some individuals may seek medical advice due to cosmetic concerns, especially if the dermolipoma is prominent.
The diagnosis of a dermolipoma involves a clinical examination performed by an ophthalmologist. The distinct appearance of the growth, presenting as a soft, yellowish-white mass firmly attached to the conjunctiva, allows for visual identification. Unlike some other growths, dermolipomas are not freely mobile and cannot be repositioned into the orbit.
Imaging tests, such as ultrasound or MRI, are rarely necessary for diagnosis. However, in atypical cases or when there is a need to assess the extent of the growth, particularly if it extends into the orbital fat, these imaging modalities might be used. A thorough eye examination also includes checking for other ocular abnormalities that can sometimes be associated with dermolipomas.
Treatment Approaches for Dermolipoma
Since dermolipomas often do not cause symptoms, observation is a management approach. If the growth remains stable and does not cause irritation or cosmetic concern, no intervention may be required. Regular eye exams can help monitor the condition over time.
Surgical removal may be considered in situations such as significant cosmetic concerns or persistent eye irritation. While true growth of a dermolipoma is uncommon, surgical intervention might also be discussed if there is a rare concern about an increase in size. The surgical procedure for dermolipoma removal is delicate, aiming to excise the visible portion without damaging surrounding structures.
Surgeons perform a partial surgical resection to remove the superficial part of the dermolipoma. This approach helps minimize potential complications, as complete or radical removal can lead to a higher incidence of complications like eyelid drooping (ptosis), misalignment of the eyes (strabismus), or injury to the lacrimal gland, which produces tears. Post-surgical considerations may include scarring, though recurrence is rare.