Capillary Hemangioma Clinical Presentation

Updated: Oct 06, 2015
  • Author: Stuart Seiff, MD, FACS; Chief Editor: Hampton Roy, Sr, MD  more...
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Presentation

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. [4] 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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