Dr. Sagar Chaudhari ( Ms Ophthalmology), Dr. Ashutosh Patil( Doms, Fgo), Dr. Rohini Waghmare ( Post Graduate Student)

1. Dr. Sagar Chaudhari ( MS
Ophthalmology)
Dr. Ashutosh Patil ( DOMS, FGO)
Dr. Rohini Waghmare ( Post Graduate
Student)
A rare case of capillary
haemangioma of eyelid in a
child.

2. INTRODUCTION:
 Capillary hemangiomas are the most common benign
tumors found in children more commonly in lid.
 These tumors show no pattern of inheritance from
either parent , nor specific ethnic or national
preference.1
 Capillary hemangiomas are caused by a proliferation
of large, aggregated endothelial cells and
anastomosing blood filled channels.
 Spontaneous resolution of the tumor is seen in many
patients. Forty percent resolve by the time a child is
four years old and 70% resolve by the age of seven.2
 Many infants are at risk for developing amblyopia,
anisometropia and strabismus.3

3. CASE REPORT:
 HISTORY
 A nine years old male child presented with a four-
month history of non fluctuating swelling of the
upper lid of right eye.
 There is no history of such lesion at the same
site till the present presentation.
Fig- 1

4.  EXAMINATION
 On examination, A well-defined, soft lesion in the
medial side of right upper eyelid could be
palpated, just below the superior orbital rim,
without associated inflammatory signs.
 It measured 0.5x0.5cm and was round to oval in
shape. (see figure 1).
 Lid position and extraocular movements were
normal, with examination of anterior and posterior
segment of both eyes revealing no abnormality.
 Both eyes had visual acuity 6/6 with intraocular
pressure 17.3mm of Hg.

5. TREATMENT
 Considering the fact that its superficial and
accessible location of the lesion, direct surgical
exicision without any local investigation was
planned.
 Patient underwent excisional biopsy of the lesion
under general anesthesia (Fig- 2 to 5) and the
mass was sent for histopathology which
conformed the diagnosis of capillary
haemangioma (Fig- 6).
 Patients had uneventful post-operative recovery.
There was no recurrence after 6 months.

6. Fig- 2
Fig- 3
Fig- 4 Fig- 5

7. DISCUSSION:
 Capillary hemangiomas are the most common
eyelid and orbital tumors of childhood.
 This tumor has been referred by many names
(infantile hemangioma, juvenile hemangioma,
hemangioblastoma, benign
hemangioendothelioma, hypertrophic
hemangioma), but is most commonly called
‘capillary hemangioma.’
 This term is most common as it accurately
describes the capillary unit structure of
endothelial cells surrounded by pericytes.4

8.  These tumors can present as small isolated
lesions, or large masses that can cause visual
impairment, systemic effects, or exist as part of a
syndrome.
Fig- 6

9.  Many capillary hemangiomas can be diagnosed
on examination, but occasionally identification
may require the use of ultrasonography,
computed tomography or magnetic resonance
imaging for accurate diagnosis.
 Understanding of this tumor, its natural history,
and the indications for treatment are necessary
for management of the tumor and to help the
patient's family understand the disease process.5
 This case is unique in being presented for the first
time at nine years of age and without any
recurrence for 6 months after surgical exicision.

10. CONCLUSION
 Superficial capillary haemangioma of the lid with
accurate surgical exicision can prevent
recurrence.

11. REFERENCES:
 1. Stigmar G, Crawford JS, Ward CM, Thomson HG.
Ophthalmic sequelae of infantile hemangiomas of the
eyelids and orbit. Am J Ophthalmol 1978;93:496-506
 2. Aguilar G, Egbert P. Eyelid tumors. Curr Opin
Ophthalmol 1992;3:333-40..
 3. Schwartz SR, Blei F, Ceisler E, et al. Risk factors for
amblyopia in children with capillary hemangiomas of the
eyelids and orbit. J AAPOS. 2006;10:262–268.
 4. Haik BG, Jakobiec FA, Ellsworth RM, Jones IS.
Capillary hemangioma of the lids and orbit: an analysis of
the clinical features and therapeutic results in 101 cases.
Ophthalmol 1979;86:760-89.
 5. Wasserman BN, Medow NB, Homa-Palladino M, Hoehn
ME. Treatment of periocular capillary hemangiomas. J
AAPOS. 2004;8:175–181