To describe a case of tarsal fibroma in a patient with a tarsal conjunctival tumor.

A 73-year-old male visited our clinic with sensations of irritation in his left upper eyelid that occurred one week prior. The patient did not have any evidence of external injuries, systemic inflammations, or any other specific findings except a history of hypertension. The best corrected visual acuity was 0.7 in the right and 0.8 in the left eye with normal IOP. On the slit-lamp biomicroscopic examinations, anterior segment showed no specific findings and the shapes and positions of the upper and lower eyelids were normal. Upon eversion of the upper eyelid, a definite solid 5 × 5-mm sized tumor with clear boundaries was observed in the upper tarsal conjunctiva. An excision biopsy was performed under local anesthesia. Gross examinations of the tumor revealed a 5 × 5 × 2-mm, gray, oval-shaped mass. On microscopic examinations, the tumor had minimal number of cells and was composed of dense collagens and scattered fibroblasts. Based on these findings, the patient was diagnosed with tarsal fibroma. The patient experienced no discomfort after the excision biopsy. At a one-year follow-up, there were no signs of recurrence.

Although rare, tarsal fibroma should be considered in the differential diagnosis of solid tarsal lesions.