A total of 145 patients with orbital dermoid cysts examined at the Orb
ital Clinic, Institute of Ophthalmology, School of Medicine, Universit
y of Naples ''Federico II'' over a period of 16 years were reviewed. T
he orbital cysts were classified as exophytic and endophytic, accordin
g to their site of attachment in relation to the orbital rims. This cl
assification can explain the different natural history of these lesion
s. The exophytic cysts growing externally are discovered in childhood,
whereas the endophytic ones are discovered later in life when they pr
oduce bone damage, with or without invasion of the adjacent structures
.