Subconjunctival prolapse of orbital fat
Contributor: Jesse Vislisel, MD
Photographer: Toni Venckus, CRA
Intraconal orbital fat can herniate into the subconjunctival space when Tenon's capsule is violated spontaneously or after trauma or surgery. This process appears as a unilateral or bilateral, elevated, compressible, yellow-orange mass with visible lipid globules. It is most commonly located in the superotemporal quadrant of the globe in elderly, obese men. The top photograph below shows orbital fat that prolapsed spontaneously, resulting in adjacent subconjunctival hemorrhage. The bottom photograph shows bilateral orbital fat prolapse in a different patient.
Source: Schmack I, Patel RM, Folpe AL, Wojno T, Zaldivar RA, Balzer B, Kang SJ, Weiss SW, Grossniklaus HE. Subconjunctival herniated orbital fat: A benign adipocytic lesion that may mimic pleomorphic lipoma and atypical lipomatous tumor. Am J Surg Pathol. 2007 Feb;31(2):193-8.
Ophthalmic Atlas Images by EyeRounds.org, The University of Iowa are licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.