A 69-year-old woman was referred for evaluation of a vascular anomaly of the conjunctiva of the right eye. She had a right orbital tumor resected 12 years previous and had been aware of the reddish spot on the nasal aspect of the conjunctiva for the past five to 10 years. Cataract surgery was performed in this eye in 2005. Over the past year, the patient felt that this painless spot had increased in size. Examination revealed a collection of dilated tortuous conjunctival vessels with two feeding sources, one superior and one inferior to the complex. The area was essentially flat with only mild elevation related to the vascular anomaly. Conjunctival fluorescein angiography revealed no vascular leakage. The findings are consistent with a conjunctival hemangioma, which is a rare but well-described variant of hemangiomas of the eye. These tend to be benign and focal, but as in this case, can undergo spontaneous enlargement. Management options include observation or local excisional biopsy with cryotherapy to the margins.
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