A yellowish subconjunctival lesion in an infant-congenital orbital fat herniation

Area of Science:

• Ophthalmology
• Pediatric Surgery
• Medical Imaging

Background:

• Congenital orbital fat herniation is an uncommon condition.
• Presents as a palpable mass in the orbital region.
• Requires accurate diagnosis for appropriate management.

Observation:

• A child presented with a progressive, small, yellowish, and mobile mass on the temporal orbital wall of the right eye.
• The mass was identified as a herniation of orbital fat.
• No contrast enhancement was observed in the magnetic resonance imaging.

Findings:

• Magnetic resonance imaging (MRI) demonstrated a fat-isointensive structure in T1-weighted sequences.
• The herniation was located on the temporal aspect of the orbit.
• The findings are consistent with orbital fat prolapse.

Implications:

• This case highlights the importance of considering rare congenital conditions in pediatric orbital masses.
• Understanding the potential aetiology, such as congenital weakness of Tenon's capsule or conjunctival fornix, aids in diagnosis.
• Further investigation may be needed to confirm the exact cause and guide treatment.