Capillary Hemangioma
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A capillary hemangioma on the eyelid is a benign growth of blood vessels that occurs commonly in infancy. It appears as a bright red raised birthmark and can cause vision problems if obstructing/pressuring the visual field. It can also impact breathing if the nostril is obstructed. Other names for this condition include infantile hemangioma, strawberry hemangioma, and strawberry nevus. These hemangiomas occur in 1:10 births and more frequently with low-birth-weight infants. They can grow quickly and then fade slowly. They are one of the most common orbital tumors in childhood and many disappear on their own.
General
Capillary hemangiomas present as strawberry red/purple-colored nevi. They are somewhat spongy in texture and can be located on the upper eyelid, lower eyelid, or deeper in the orbit. They are typically unilateral and present within the first weeks or months of life. They tend to grow rapidly for six months to one year.
Systemic Evaluation
These hemangiomas occasionally coincide with other hemangiomas.
Risks / Significance
Vision concerns related to these growths on the eyelid include strabismus or myopia perhaps leading to amblyopia (lazy eye); obstruction of the visual axis; and astigmatism related to the tumor position of tumor.
Differential Diagnosis Imaging
Imaging capillary hemangiomas can help differentiate diagnosis by providing more information on the growth. CTs/MRIs can show well circumscribed lesions and can distinguish orbital cellulitis, rhabdomyosarcoma, lymphangioma, and orbital dermoid.
Pathogenesis
These hemangiomas on the eyelid are characterized by an increased number of endothelial cells and may shrink over time. These extra blood cells are closely packed for poorly understood reasons.
Treatment / Medical /Surgery
When these orbital capillary hemangiomas result in amblyopia or ptosis (droopy eyelids), some vision loss is possible. Patients may need to be managed closely for amblyopia, or prescribed steroids to control growth. Radiation and CO2 laser application may be helpful. Surgical intervention is infrequent, particularly because many hemangiomas shrink over time.
