Eyelid

Capillary Hemangioma

The most common orbital and eyelid tumor of childhood — a benign 'strawberry' vascular birthmark that usually fades on its own but can threaten vision when it blocks or presses on the eye.

Medically reviewed by Tamara R. Fountain, MDOculoplastic SurgeonLast updated June 2026

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Part of our complete guide to Orbital Tumors — this page covers capillary hemangioma in depth.

What Is a Capillary Hemangioma?

A capillary hemangioma (also called an infantile or “strawberry” hemangioma) is a benign tumor of rapidly growing blood-vessel cells — and the most common orbital and periorbital tumor of childhood. It appears in the first weeks of life as a raised, red or bluish, spongy lesion; about 60% occur on the head and neck. The upper eyelid is involved more often than the lower, and lesions deep in the orbit can push the eye forward (proptosis). It is more common in girls and in low-birth-weight infants.

Capillary (strawberry) hemangioma involving the eyelid of an infant — A superficial capillary hemangioma — raised, red, and spongy, typically appearing in the first weeks of life.

Natural History: Growth, Then Fading

The pattern is predictable: rapid growth for roughly the first 6–12 months (the lesion may darken and swell with crying), then a plateau, then slow spontaneous shrinkage (involution) beginning around age one. About 60% have resolved by age 5 and 90–95% by age 9. Because most disappear on their own, many hemangiomas are simply observed — unless vision is at risk.

When Vision Is at Risk

An infant’s visual system is still wiring itself to the brain; anything that degrades the image in one eye can cause amblyopia (permanent “lazy eye”). An eyelid or orbital hemangioma can do this three ways:

Occlusion — the lesion physically covers the pupil
Induced astigmatism — pressure on the globe distorts its shape and blurs the image
Strabismus — orbital mass effect misaligns the eyes

Every periocular hemangioma therefore needs ophthalmic monitoring during the growth phase, even when no treatment is planned. Multiple lesions occasionally warrant systemic evaluation (rarely, visceral involvement or Kasabach–Merritt syndrome).