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Orbit and eyelid hemangiomas: is there a relationship between location and ocular problems?

Dubois J, Milot J, Jaeger BI, McCuaig C, Rousseau E, Powell J

Department of Medical Imaging, Ste-Justine Mother-Child University Hospital, Montreal, Quebec, Canada. josee-dubois@ssss.gouv.qc.ca

PURPOSE: Infantile hemangiomas of the orbit and eyelid can cause serious ocular problems, such as astigmatism and amblyopia. Magnetic resonance imaging and ultrasonography are the best ways to establish the diagnosis and to evaluate the extent of the lesion. Our goal was to correlate the lesion location with the visual impairment. MATERIAL AND METHODS: This was a retrospective study (1992-2004) of 63 cases of orbit and eyelid hemangiomas (13 male, 50 female patients; ages: 1 day old to 3 years old). Imaging methods were magnetic resonance imaging or computed tomographic-scanning and color Doppler ultrasonography. The anatomic definition was palpebral, extraconal, and extraconal with intraconal involvement. All patients had ophthalmologic evaluations. RESULTS: The hemangiomas were palpebral (n = 32) (normal vision: 19; amblyopia and/or astigmatism: 13), extraconal, and extraconal with intraconal involvement (n = 31) (normal vision: 4; amblyopia and/or astigmatism: 27). LIMITATIONS: This study was small; a prospective study is needed. CONCLUSION: Orbit and eyelid hemangiomas need to be carefully evaluated by an ophthalmologist. Extraconal and intraconal hemangiomas are more frequently associated with ocular involvement. However, ocular complications can occur in palpebral lesions.

Published 2 October 2006 in J Am Acad Dermatol, 55(4): 614-9.
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