In a child with a large left upper eyelid hemangioma causing mechanical ptosis and occlusion amblyopia, the priority treatment is:
- A Observation until spontaneous involution by age 7
- B Systemic propranolol to accelerate involution, with patching of the normal eye to treat amblyopia ✓
- C Surgical excision at birth to prevent permanent visual loss
- D Intralesional triamcinolone injection alone
Correct answer: B. Systemic propranolol to accelerate involution, with patching of the normal eye to treat amblyopia
Explanation
Capillary hemangiomas causing visual deprivation amblyopia in children require urgent treatment. Systemic propranolol (oral, 1–3 mg/kg/day) is now the first-line treatment for large or vision-threatening hemangiomas, as it accelerates involution with high efficacy and good safety profile. Concurrent patching of the fellow eye treats amblyopia by forcing use of the amblyopic eye. Observation risks irreversible amblyopia. Surgery is second-line for unresponsive cases.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.