Subconjunctival Lipid Leakage From Deep Orbital Dermoid Cysts

Orbital dermoid cysts are fairly common and arise by sequestration of surface ectoderm along skeletal suture lines during embryologic development. Although anterior dermoid cysts are generally evident in infancy, deeper cysts typically present with inflammatory symptoms in adulthood. The authors report the clinical and imaging features for 6 cases of deep orbital dermoid cysts that were identified by the presence of subconjunctival lipid droplets; to the authors' knowledge, this case report represents the largest series of dermoids with such a presentation. In the absence of prior vitreoretinal surgery, subconjunctival lipid droplets are an important clinical sign suggesting the presence of a deep orbital dermoid cyst.