Orbital dermoid cysts presenting as subconjunctival fat droplets.

The authors report 3 cases of orbital dermoid cysts presenting with subconjunctival fat droplets. Three female patients were evaluated for conjunctival injection and yellowish granular material lying under the bulbar conjunctiva in the left eye. Slit-lamp examination showed a number of subconjunctival fat droplets in the involved eyes. Orbital CT and MRI in each case revealed a cystic mass located in the superotemporal aspect of the left orbit. The masses were excised via lateral orbitotomy in 2 patients, and a conjunctival biopsy of the granular material was performed in 1 patient. The cystic masses were histopathologically diagnosed as dermoid cysts with findings of lipogranuloma that suggested a previous rupture of the cyst itself. Examination of the conjunctival specimen also suggested lipogranuloma. Orbital dermoid cysts should be considered in patients presenting with subconjunctival fat droplets.