Capillary Hemangioma Clinical Presentation

  • Author: Stuart Seiff, MD, FACS; Chief Editor: Hampton Roy Sr, MD   more...
 
Updated: Jul 29, 2011
 

History

  • The history can be quite variable in this group of patients. Typically, parents may notice a red spot growing in size and thickness in the periorbital area.
  • The parents may be acutely aware of a gradual inability of the child to open an affected eye due to progressive involvement of the eyelid.
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Physical

  • Patients usually present with a unilateral, superonasal eyelid or brow lesion. It typically blanches with pressure, unlike the lesions seen with port-wine stains. The mass lesion may be sufficient to cause a ptosis of the involved eyelid. Alternatively, if the lesion extends posteriorly in the orbit, proptosis and visual loss may be present.
  • Examination of the visual system may reveal decreased visual acuity on the ipsilateral side.
  • Unfortunately, amblyopia is seen in 43-60% of patients with eyelid hemangiomas.
  • Anisometropia also can be found on examination as a result of the mass effect on the cornea. The axis of plus cylinder is usually toward the hemangioma.
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Causes

Capillary hemangiomas are believed to be hamartomatous proliferations of vascular endothelial cells.

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Contributor Information and Disclosures
Author

Stuart Seiff, MD, FACS  Emeritus Professor of Ophthalmology, University of California, San Francisco, School of Medicine; Chief, Department of Ophthalmology, San Francisco General Hospital; Consultant, Oculofacial and Aesthetic Plastic Surgery, California Pacific Medical Center and Mills Peninsula Medical Center

Stuart Seiff, MD, FACS is a member of the following medical societies: American Academy of Ophthalmology, American Society of Ophthalmic Plastic and Reconstructive Surgery, and California Medical Association

Disclosure: Nothing to disclose.

Coauthor(s)

Orin M Zwick, MD  Oculoplastic Surgeon, Chesapeake Eye Care and Laser Center

Orin M Zwick, MD is a member of the following medical societies: American Academy of Ophthalmology and American Medical Association

Disclosure: Nothing to disclose.

Dan D DeAngelis, MD, FRCS(C)  Lecturer, Ophthalmic Plastic and Reconstructive Surgery, Assistant Professor, Department of Ophthalmology and Vision Sciences, University of Toronto Faculty of Medicine; Ophthalmologist, Department of Ophthalmology and Vision Sciences, Hospital for Sick Children

Dan D DeAngelis, MD, FRCS(C) is a member of the following medical societies: American Academy of Ophthalmology, American Society of Ophthalmic Plastic and Reconstructive Surgery, California Medical Association, Canadian Medical Association, Canadian Ophthalmological Society, Ontario Medical Association, and Royal College of Physicians and Surgeons of Canada

Disclosure: Nothing to disclose.

Susan Carter, MD  Clinical Associate Professor of Ophthalmology, Institute of Ophthalmology and Visual Science, New Jersey Medical School

Susan Carter, MD is a member of the following medical societies: American Academy of Ophthalmology and American Society of Ophthalmic Plastic and Reconstructive Surgery

Disclosure: Nothing to disclose.

Specialty Editor Board

Brian A Phillpotts, MD  Former Vitreo-Retinal Service Director, Former Program Director, Clinical Assistant Professor, Department of Ophthalmology, Howard University College of Medicine

Brian A Phillpotts, MD is a member of the following medical societies: American Academy of Ophthalmology, American Diabetes Association, American Medical Association, and National Medical Association

Disclosure: Nothing to disclose.

Simon K Law, MD, PharmD  Associate Professor of Ophthalmology, Jules Stein Eye Institute, University of California, Los Angeles, David Geffen School of Medicine

Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, and Association for Research in Vision and Ophthalmology

Disclosure: Nothing to disclose.

Mark T Duffy, MD, PhD  Consulting Staff, Division of Oculoplastic, Orbito-facial, Lacrimal and Reconstructive Surgery, Green Bay Eye Clinic, BayCare Clinic; Medical Director, Advanced Cosmetic Solutions, A BayCare Clinic

Mark T Duffy, MD, PhD is a member of the following medical societies: American Academy of Ophthalmology, American Medical Association, American Society of Ophthalmic Plastic and Reconstructive Surgery, Sigma Xi, and Society for Neuroscience

Disclosure: Allergan - Botox Cosmetic Consulting fee Consulting

Lance L Brown, OD, MD  Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri

Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD  Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences

Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the assistance of Ryan I Huffman, MD, with the literature review and referencing for this article.

References

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  18. Al Dhaybi R, Superstein R, Milet A, Powell J, Dubois J, McCuaig C, et al. Treatment of periocular infantile hemangiomas with propranolol: case series of 18 children. Ophthalmology. Jun 2011;118(6):1184-8. [Medline].

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