Oculoplasty · Capillary hemangioma

Hemorrhagic lesion near medial canthus

Differentials include: Vascular/reactive lesions 1. Pyogenic granuloma – rapidly growing, friable, vascular nodule that bleeds easily with minor trauma; very common at lid margins, especially after a chalazion, stye, or minor injury 2. Capillary hemangioma – vascular, can bleed if traumatized 3. Ruptured telangiectasia/dilated vessel – isolated bleeding vessel without a true "mass" Cystic/glandular lesions 1. Chalazion (lipogranuloma) with secondary ulceration/bleeding – blocked meibomian gland, can erode through skin/conjunctiva and bleed 2. Hordeolum (stye) – infected gland, can rupture and bleed 3. Sebaceous cyst with rupture Papillomatous/growth lesions 1. Squamous papilloma – benign, can be pedunculated and bleed if caught or scratched 2. Molluscum contagiosum – less classically bleeding, but can be irritated Traumatic causes 1. Lid margin laceration or excoriation – from scratching, fingernail injury (a finger is visibly pressing near the eye in the photo, so mechanical trauma is worth considering), foreign body, or eyelash pulling 2. Foreign body granuloma

Contributed byDr. Mohammed Arif KaderiResident, JNMC, Wardha

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