Congenital Central Corneal Dermoid: A Rare Case Presentation

This case report emphasizes the diagnosis, surgical treatment, and histopathological findings of a central corneal dermoid, which presents differently than the more common inferotemporal epibulbar location.

Tertiary Care Centre in Western India

A male child, aged one year, was delivered from a twin gestation at 35 weeks of gestation and presented with a progressively enlarging corneal mass in left eye since birth. Clinical examination revealed a vascularized brownish lesion measuring 7 mm by 7 mm located in the central and paracentral regions of the cornea, with sparing of the peripheral cornea. Given the substantial involvement of the visual axis, the patient underwent surgical excision followed by penetrating keratoplasty.Intraoperatively, congenital cataract with corneo-irido-lenticular adhesions were noted. Histopathological analysis confirmed the presence of stratified squamous epithelium exhibiting surface keratinization, collagenous thickening, smooth muscle fibers, and inflammatory infiltrates, consistent with a diagnosis of a solid corneal dermoid.

Corneal dermoids, although infrequent, should be considered in the evaluation of congenital corneal opacities and distinguished from other anterior segment anomalies. Early surgical intervention, such as keratoplasty, is essential to prevent amblyopia and enhance visual outcomes in cases involving the visual axis. Histopathological examination and immunohistochemistry are pivotal in confirming the diagnosis and elucidating the composition of the lesion. This particular case is noteworthy as it presents a central corneal dermoid that lacks limbal involvement, representing a rare deviation from the more prevalent epibulbar dermoids