The posterior eye-wall appears flattened. Histopathologic sections stained with hematoxylin and eosin demonstrate the large vascular channels with smooth muscle in the vascular walls as associated with cavernous orbital hemangioma. Histopathologic sections with elastin-stain also demonstrate the large loosely distributed vascular channels associated with orbital hemangioma. The tumor's capsule is noted on the right. Left, a fundus photograph demonstrates choroidal folds induced by the tumor indenting the posterior eye-wall.
Orbital hemangiomas are typically slow-growing lesions.
Treatment is indicated for growth, optic nerve compression, corneal exposure with secondary keratitis sicca, or evidence of vision loss. The goal of local resection should be complete removal of the tumor. This usually involves blunt dissection of the tumor maintaining the integrity of the tumor's capsule. Connecting vascular feeder vessels should be identified and cauterized. A lateral orbitotomy is usually required to keep the large tumor intact.