Abstract

Case report of 1-year-old child presenting with swelling near left lacrimal sac since age of 2 months, increasing in size with episodes of URTI; regressed after Intralesional Bleomycin injection. Lesion increased 15 days later; the swelling has become tense since last 15 days. On examination there was a purplish tense cystic swelling 20mm x 20mm in size in infraorbital space. Superior globe dystopia > Proptosis; visual axis obscured. Extraocular motility is full. T2 weighted MRI showed multi-lobulated hyperintense cystic lesion in left intraconal space extending into inferior and medial extraconal space with fluid – fluid levels suggestive of Lymphangioma with intralesional bleed (Chocolate cyst). Parents were explained about need for drainage of lesion followed by Injection of Bleomycin (sclerosing agent) under GA, chances of recurrences, need for repeated injections and Amblyopia therapy.