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Chapter-60 Orbital Disorders: Vascular Abnormalities

BOOK TITLE: Surgical Techniques in Ophthalmology (Pediatric Ophthalmic Surgery)

Author
1. Grover AK
2. Bageja Shaloo
ISBN
9789350251485
DOI
10.5005/jp/books/11282_60
Edition
1/e
Publishing Year
2011
Pages
4
Author Affiliations
1. Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi, Sir Ganga Ram Hospital, New Delhi; Vision Eye Centre, New Delhi, India, Sir Ganga Ram Hospital and Vision Eye Center, New Delhi, India, Sir Ganga Ram Hospital; Vision Eye Center, New Delhi, India, Sir Gangaram Hospital, Rajender Nagar, New Delhi, India, Sir Gangaram Hospital, New Delhi, Sir Ganga Ram Hospital, New Delhi, India, Sir Ganga Ram Hospital, Director, Vision Eye Clinic, 12/27, West Patel Nagar, Near Arya Samaj Mandir, New Delhi, India, Sir Ganga Ram Hospital, Rajender Nagar, New Delhi, India, Ganga Ram Hospital, New Delhi, India, Sir Ganga Ram Hospital, Rajinder nagar, New Delhi, India, Department of Ophthalmology, Sir Gangaram Hospital, Rajinder Nagar, New Delhi, India
2. Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi, Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi, India, Sir Ganga Ram Hospital, Rajender Nagar, New Delhi, India, Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi (India), Vision Eye Clinic, 12/27, West Patel Nagar, Near Arya Samaj Mandir, New Delhi, India, Sir Gangaram Hospital, Rajender Nagar, New Delhi, India, Sir Ganga Ram Hospital, New Delhi, India
Chapter keywords

Abstract

Orbital lesions in pediatric age group are of extreme concern. Capillary hemangioma is the most common orbital tumor in children. It is diagnosed at birth or in the first six months of life. They are most commonly situated in the upper lid or orbit. Cutaneous lesions are known as strawberry nevus. These tumors can cause proptosis, ptosis, strabismus, astigmatism and amblyopia. CT scan shows homogenous soft tissue density. Amblyopia is the most common indication for treatment. Intralesional corticosteroid, i.e. a combination of triamcinolone and dexamethasone is a preferred treatment. These lesions increase in size in the first year of life and spontaneously regress over the years. Lymphangioma is a benign vascular tumor that becomes apparent in the first decade of life. It may involve eyelid, conjunctiva and orbit.They may present as a slowly progressive proptosis or sudden presentation due to hemorrhage following a trivial trauma.Imaging studies show the multicompartmental nature of the venous-lymphatic malformations. Surgical debulking is the treatment of choice. Cavernous hemangioma are benign well encapsulated vascular tumor. They may be present at birth, but usually occur later. They gradually increase in size manifesting as proptosis and visual impairment. Diagnosis is established by ultrasonography and CT scan. Removal of mass en toto via orbitotomy. Orbital varices are the most common congenital venous malformation.It usually presents as intermittent proptosis with dilated conjunctival or lid vessels. The proptosis increases with Valsalva maneuver or while straining. Diagnosis can be established by orbital venography or CT scan. Surgical intervention may be necessary in nonresolving episodes of thrombosis, severe proptosis and optic nerve compression. Prognosis is excellent in cavernous hemangioma where recurrence is rare, in the rest of the tumors complete removal is not possible.

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