Purpose:

To study the effect of intralesional bleomycin in case of orbital lymphangioma in a 7 year old female.

Methods:

A 7 year old female came to our institution with complaints of swelling , restriction of ocular movements in upward and downward direction ,eyeache and sudden diminision of vision within 3 days. She was having visual acuity of Right eye 6/6 and Left eye counting fingers 6meters with eccentric proptosis and having left eye upper lid and lower lid edema with ecchymosis. Patient was investigated with MRI orbit with report of retro orbital mass with proptosis suggestive of lymphangioma. Intralesional Injection of bleomycin was administered under guidance of ultrasonography. Postoperative follow up was good and uneventful.

Results:

Orbital lymphangioma presents usually in childhood.The most frequent presenting feature of orbital lymphangiomas are proptosis and ptosis of the affected eye.The symptoms are not clinically present until an inciting factor causes an increase in size of the lesion.It is often due to mild trauma causing hemorrhage in the lesion or acute upper respiratory infection leading to swelling of lesion The management falls in 4 categories 1)Observation 2)Sclerotherapy3)Systemic medication4)Surgery Visual acuity of patient improved to Right eye 6/6 and Left eye 6/18 from visual acuity of left eye counting fingers 6 meters on post operative day 1 with resolution of papilloedema and decrease in proptosis

Conclusions:

A significant improvement is seen after the administration of Intralesional injection of bleomycin with improvement in visual acuity, orbital movement , proptosis and resolution of papilloedema.