Session: Poster session A

Conservative treatment of Esotropia associated with eyelid and orbital hemangioma

Background: Hemangiomas are the most common benign tumor of infancy. Most hemangiomas remain asymptomatic and can be managed by close observation. Large facial hemangiomas can have associated central nervous system malformations,abnormal arteries, especially those of the central nervous system, coarctation of the aorta, cardiac defects, and unusual ophthalmologic abnormalities can also occur. 



Observations: We describe a child with large congenital hemangiomas of the face affecting the left eye, orbit and eyelid and structural arterial abnormalities of the left orbit. The child was properly monitored. Digital subtraction angiography was performed. After emergency excision of intracranial arteriovenous malformation, postoperative esotropia occurs. We approach the conservative method of treating esotropia with limited abduction of the left eye. In three months of treatment, we managed to bring the deviation angle of 30 prism diopters back into the ortho position. 



Conclusion: A large congenital hemangioma required a multidisciplinary approach involving early vascular embolization of feeder vessels and subsequent surgical resection. Conservative treatment options for esotropia include observation, occlusion, optics, orthoptic exercises, and prisms. Their eye condition should be monitored when treatment is started, and therapy should be changed if necessary. The success of therapy is largely based on appropriate patient selection and compliance level.