She now has a third hemangioma. This one is on her eyelid. We had a pediatric dermatologist check out yesterday and it's the one they are most concerned about even though it's the smallest in size. She has a very large one on her shoulder that the doctor feels should go away. It may leave a little bit of loose skin though. We will have to take her every 2 weeks to the doctors so they can keep an eye on it. It could affect her vision if it gets worse.
Capillary hemangiomas are typically found at birth. They will grow during the first decade and most will shrink (involutes). If they involve the eyelids, they can cover the eye and cause loss of vision (amblyopia). It is very important that children with capillary hemangiomas be seen by a pediatric ophthalmologist and eye cancer specialist as soon as it is found.
Capillary hemangioma is diagnosed by clinical examination. It has a typical appearance and biopsy is rarely needed. It appears as a reddish tumor or mass beneath the skin. The eye care specialist will order a radiographic scan (MRI or CT) to see how deep the tumor extends into the orbit (around the eye).
The pediatrician should be advised and the child inspected for hemangiomas on other parts of the body.
Observation for spontaneous resolution is commonly performed. If the tumor is blocking the eye and causing loss of vision (amblyopia), then it can be injected with steroid solution. This will shrink the tumor in an effort to uncover the eye. Rarely, surgery is required to remove very large tumors.
The pediatric ophthalmologist will likely suggest that the other "good" eye be periodically covered with a patch to strengthen the "bad" eye and prevent vision loss.
She certainly doesn't seem to be bothered by it yet!