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Subconjunctival fat herniation

Photo by Professor Chua

This 82-year old woman was alarmed by the appearance of yellowish lesions arising from the lateral corners of both eyes. The lesions had been present for the past 6 months and appear to enlarge. She had no history of previous eye surgery or trauma The feature was typical of subconjucntival fat herniation which resulted from dehiscence of the Tenon's capsules.

 

This condition is often spontaneous and appeared most often in the elderly and obese patients. The location of the herniation is typically between the superior and lateral recti muscles as in this patient. The treatment involves excision of the herniated fat through subtenon approach.

 

Bilateral subconjunctival fat herniation presenting as yellowish lesions in the lateral corners of the eyes.   Excision of the fat via subtenon approach. After the fat was excised, the conjunctiva was closed with 10/0 nylon.     Excision of the right herniated fat via subtenon approach. Again the conjunctiva was closed with 10/0 nylon at the end of the operation.   The eyes at one week post-operative.

Atlas of Oculoplastic Surgery