eMedicine Specialties > Ophthalmology > Orbit

Hemangioma, Capillary: Follow-up

Author: Stuart Seiff, MD, FACS, Emeritus Professor of Ophthalmology, University of California San Francisco; Chief, Department of Ophthalmology, San Francisco General Hospital; Consultant, Oculofacial and Aesthetic Plastic Surgery, California Pacific Medical Center and Mills Peninsula Medical Center
Coauthor(s): Orin M Zwick, MD, Oculoplastic Surgeon, Chesapeake Eye Care and Laser Center; Dan D DeAngelis, MD, FRCS(C), Ophthalmic Plastic and Reconstructive Surgery, Assistant Professor, Department of Ophthalmology and Vision Sciences, University of Toronto; Susan Carter, MD, Clinical Associate Professor of Ophthalmology, Institute of Ophthalmology and Visual Science, New Jersey Medical School
Contributor Information and Disclosures

Updated: Jun 18, 2009

Follow-up

Further Inpatient Care

  • Young patients may require inpatient admission and monitoring if high doses of systemic steroids are administered.

Further Outpatient Care

  • Concerns must be reiterated about ensuring that children with potentially amblyogenic capillary hemangiomas obtain frequent assessments of their visual acuity and refraction. Treatment would be indicated if astigmatism is greater than 1.5-2 diopters or if there is occlusion of the visual axis.

Inpatient & Outpatient Medications

  • Patients started on systemic steroids may need to be monitored continually on an outpatient basis until either an adequate response is seen or complications preclude its continuation.

Prognosis

  • The prognosis for cosmetic and visual recovery is excellent if treatment is instituted at an appropriate time and careful attention is paid to the visual development. Most lesions involute by age 5 years.

Miscellaneous

Medicolegal Pitfalls

  • The primary concern with capillary hemangiomas is related to their ability to cause permanent, dense amblyopia with the potential for an irrecoverable loss of vision. Close collaboration with ophthalmologists is essential to ensure that sudden changes in vision are promptly detected and treated.
  • Vision loss after intralesional corticosteroid injection is a concern of all specialists managing this problem. Parents should be informed of this risk but also cautioned against withholding treatment on the basis of this rare event.
 
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.



More on Hemangioma, Capillary

Overview: Hemangioma, Capillary
Differential Diagnoses & Workup: Hemangioma, Capillary
Treatment & Medication: Hemangioma, Capillary
Follow-up: Hemangioma, Capillary
References
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References

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Further Reading

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Keywords

capillary hemangioma, capillary hemangiomas, orbital tumor, benign endothelial cell neoplasm, vascular malformation, vascular anomaly

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Contributor Information and Disclosures

Author

Stuart Seiff, MD, FACS, Emeritus Professor of Ophthalmology, University of California San Francisco; 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), Ophthalmic Plastic and Reconstructive Surgery, Assistant Professor, Department of Ophthalmology and Vision Sciences, University of Toronto
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.

Medical Editor

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.

Pharmacy Editor

Simon K Law, MD, PharmD, Assistant Professor of Ophthalmology, Jules Stein Eye Institute; Chief of Section of Ophthalmology Surgical Services, Department of Veterans Affairs Healthcare Center, West Los Angeles
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.

Managing Editor

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; Quest medical - lacrimal balloons Honoraria Speaking and teaching; Ortho-Neutrogenia Consulting fee Consulting

CME Editor

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.

 
 
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