Capillary hemangiomas are strawberry or bluish-colored nevi. They are soft and spongy to touch. They are often multiple and frequently have a positive family history. They can increase in size with crying or dependent positions. The typical history is that they appear in the first several weeks of life and grow rapidly for approximately six months to one year. Spontaneous involution starts approximately at one year old and continues until age five or six. Capillary hemangioma occurs in approximately 1-2% of infants.
When capillary hemangioma occurs on the eyelid or periorbital area, it is imperative to have a complete eye exam to make sure the vision is not affected. The vision can be affected in any of the following ways by:
Occluding the visual axis;
producing anisometropia, leading to amblyopia;
producing strabismus, leading to amblyopia.
Early treatment of capillary hemangiomas is indicated for any of the above three reasons, as well as in the presence of a rapidly growing tumor that could potentially lead to decreased vision. Treatment includes intralesional steroid injection, carbon dioxide laser, and rarely surgery. Early surgery can result in extensive scarring and rebound growth.