General | Systemic Evaluation | Risks / Significance | Differential Diagnosis | Imaging | Pathogenesis | Pathology | Treatment / Medical /Surgery | Amblyopia Management | Corticosterioid | Observation | Radiation | Interferon | CO2 Laser | Sponsors | Bottom of page

General

Color: strawberry or reddish-bluish-colored nevi

Texture: spongy

Location: upper eyelid more than lower eyelid; also occurs in the deep orbit (leads to proptosis)

Number: usually unilateral, often multiple

Family history: often

Size / Position: can increase in size with crying or positions in which they are lower to the ground

Presentation / Onset : appear in the first eight l weeks of life

Rate of growth: rapidly for approximately six months to one year

Natural history: spontaneous involution starts approximately at one year through age 6

Incidence: occurs in approximately 1-4% of infants, may be more common in boys (3:2), more common in low birth weight infants.

 

Systemic Evaluation

• occasional additional hemangiomas
• usually no other significant involvement (EXCEPTION: Kasabach-merritt Syndrome)

 

• Risks / Significance
• Vision can be affected in several ways  
  • inducement of strabismus which my lead to amblyopia
  • occlusion of the visual axis
  • inducement of astigmatism (related to position of tumor) and or myopia which may lead to amblyopia; refractive error may persist even after resolution of tumor

• Differential diagnosis
• orbital cellulitis
• rhabodmyosarcoma
• lymphangioma
• orbital dermoid

• Imaging

• CT - well circumscribed lesion
• MRI - well circumscribed lesion

Pathogenesis

• poorly understood

Pathology

• tumor composed of numerous closely packed capillaries.
• proliferation of well-differentiated capillary endothelial cells

Treatment / Medical /Surgery

Not all orbital hemangiomas need to be removed. If, however, there is evidences of amblyopia or significant Ptosis ('Ptosis is also known as Blepharoptosis. It refers to an eyelid which is droopy. This may cause a loss of vision, especially while reading, headaches, and eyebrow strain.') treatment may be initiated as outlined below:

• Amblyopia management
• Corticosterioid
  • Oral
  • Topical
  • Local injection
    •    mixture of Kenalog and Celestone soluspan
• Observation
  • appropriate for small, non-visually threatening tumors

• Radiation
• Interferon
• CO₂ Laser

Right Upper lid capillary hemangioma	6 weeks after steroid injection