Diagnosis and Excision of Subconjunctival Herniation of Orbital Fat

Abstract

In cases of HOF, appropriate and accurate testing is essential, as this condition can mimic several other neoplasms, all of which require specialized treatment strategies. If cosmesis is unacceptable to the patient or the lesion impedes normal ocular function, a subconjunctival excision of the excess fat may be performed with little concern of recurrence. This article discusses a case of HOF, with an explanation of testing and treatment options.

Orbital Fat Prolapse

“…Extraconal fat prolapse is common, but subconjunctival HOF, which is benign, is rare. 1,2 Patients may present with symptoms of dry eyes, discomfort, or cosmetic complaints. 1,3 Clinically, subconjunctival HOF is typically located in the superotemporal quadrant and appears as a soft, yellow mass that is easily displaced using a cotton-tip applicator.…”

“…1,2 Patients may present with symptoms of dry eyes, discomfort, or cosmetic complaints. 1,3 Clinically, subconjunctival HOF is typically located in the superotemporal quadrant and appears as a soft, yellow mass that is easily displaced using a cotton-tip applicator. 3,4 These characteristics help distinguish it from conjunctival dermolipoma, conjunctival lymphoma, epidermoidal cyst, and prolapse of the lacrimal gland.…”

“…3,4 These characteristics help distinguish it from conjunctival dermolipoma, conjunctival lymphoma, epidermoidal cyst, and prolapse of the lacrimal gland. [1][2][3][4] Orbital computed tomography or magnetic resonance imaging identifies subconjunctival HOF as a low-density mass continuous with the intraconal fat. 1,2,4,5 Histopathologic analysis reveals normal adipose tissue.…”

“…[1][2][3][4] Orbital computed tomography or magnetic resonance imaging identifies subconjunctival HOF as a low-density mass continuous with the intraconal fat. 1,2,4,5 Histopathologic analysis reveals normal adipose tissue. 5 Subconjunctival HOF is managed using transconjunctival excision.…”

“…5 Subconjunctival HOF is managed using transconjunctival excision. 1,5 Extraconal fat protrusion can be corrected with blepharoplasty. 2 (doi:10.7556 /jaoa.2018.127)…”