Large orbital hemangioma: managed with systemic propranolol

Area of Science:

• Ophthalmology
• Pediatrics
• Dermatology

Background:

• Infantile hemangiomas are common benign vascular tumors in infants.
• While many resolve spontaneously, some require intervention due to functional impairment or complications.
• Orbital hemangiomas can threaten vision and require prompt management.

Observation:

• A 5-month-old infant presented with a large left-sided orbital hemangioma.
• The hemangioma completely obscured the palpebral fissure, posing a risk to vision.
• The infant had no other significant medical history.

Findings:

• The infant was successfully managed with oral propranolol therapy.
• Propranolol led to significant regression of the orbital hemangioma.
• Visual function was preserved, and the palpebral fissure was no longer obscured.

Implications:

• Oral propranolol is an effective treatment for large orbital infantile hemangiomas.
• Early intervention with propranolol can prevent long-term visual impairment.
• This case highlights the importance of considering systemic propranolol for visually significant infantile hemangiomas.