Dr. William R. Katowitz reviews the management of orbital swelling in children, which can present as malformations, inflammations or tumors. Venolymphatic malformation (VLM), or lymphangioma, are no- or low-flow vascular malformations that can cause sudden or progressive proptosis. Treatment can be required for optic neuropathy, exposure neuropathy, amblyopia and appearance, and can include systemic steroids for flairs, surgery or sclerotherapy. Myositis is the most common presentation of pediatric idiopathic orbital inflammation syndrome. A congenital dermoid cyst should be completely excised after the age of six months, whereas infantile capillary hemangioma can be managed with observation, surgical debulking, medical intervention, steroids or beta-blockers.