Orbital dermoid

What is perception?

This lady had no idea that her eyes looked “different”. To her it is normal.

Yet the photo shows a clear problem that no one picked up.

The scan shows the answer…a huge dermoid medial to the eye, pushing the eye out and up.

It is like having a second eye in the eye socket.

The problem here is that the orbital dermoid has expanded the eye socket, so that after I remove it, she may end up with a slightly sunken appearance!

Question: That is huge! Was she referred by her optometrist or GP? Was she getting any symptoms?

Answer:

I agree, on the scans it looks massive.

Here is the issue…it is slow growing, and the patient nor their family recognized the change in her appearance.

THIS WAS IN INCIDENTAL PICKUP after having scans for her teeth!
Hard to believe but true.

The moral here is this: just look at a patient, and if you think there is a problem, trust your clinical gut decision.

We are not good at picking up slow change.

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