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Capillary hemangioma of the eye
Last reviewed: 04.07.2025
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Capillary hemangioma of the eye is the most common tumor of the orbit and periorbita in children. This hamartoma may be a small, isolated, clinically insignificant lesion or it may be large, disfiguring, and cause visual impairment and systemic complications.
To diagnose capillary hemangioma of the eye, an examination is usually sufficient. The formation can be superficial, subcutaneous, deep, or combined with various defects and eye symptoms.
It usually appears in the perinatal period, but never at birth.
[ Symptoms of capillary hemangioma of the eye
- Superficial "strawberry" nevus on the eyelids is a common symptom.
- Subcutaneous hemangioma of the eyelids or anterior orbit shows through the overlying skin as a dark blue or purple color.
- Frequent localization of the tumor is the superior anterior part of the orbit; it may be accompanied by dystopia.
- A deep orbital tumor causes exophthalmos without discoloration of the skin.
- Hemangiomatous lesions of the eyelids and conjunctival fornices can usually serve as an important diagnostic sign.
- Large tumors may enlarge and change color to a deep blue when crying or exerting physical effort and are never accompanied by pulsation or noise.
- In 25% of cases, there are capillary hemangiomas in other parts of the body.
CT is required for deep lesions when the diagnosis cannot be made by examination. CT shows a volumetric homogeneous soft tissue formation in the anterior part of the orbit or outside the muscular cone, the posterior part of which resembles a finger. The orbital cavity may be enlarged, but there is no bone erosion.
Course of capillary hemangioma of the eye
Growth is characteristic during the first year of life, followed by gradual involution, starting from the age of 2. Complete resorption occurs by the age of 4 in 40% of cases and by the age of 7 in 70%.
System combinations
Children with large hemangiomas may suffer from:
- Heart failure.
- Kasabach-Meritt syndrome, characterized by thrombocytopenia, anemia, and low levels of clotting factors.
- Moffuci syndrome, characterized by cutaneous hemangiomas, chondropathy of the hands, feet, long bones and their curvature.
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How to examine?
Treatment of capillary hemangioma of the eye
Indications
- Amblyopia, often secondary due to astigmatism and anisometropia.
- Compression of the optic nerve.
- Exposure keratopathy.
- Severe cosmetic defect, necrosis or infection.
Treatment methods for capillary hemangioma of the eye
- steroid injection (triamcinolone acetonide 40 mg with betamethasone 6 mg) locally is very effective in subcutaneous localization in the early active stage. Possible complications include retrograde forced entry of the solution into the central retinal artery, skin depigmentation and necrosis, bleeding and atrophy of fatty tissue;
- Systemic administration of steroids daily for several weeks may also be effective, especially if there is an extensive orbital component;
- local resection with cauterization can reduce the volume of anteriorly located, limited tumor, but it is usually used in late inactive stages;
- low dose radiotherapy.