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Obvious proptosis of the left eye

This infant was presented as shown in the pictures above at age three weeks. The baby was normal for ten days and then the left eye began to protrude. The baby was seen in another clinic and the mother was told the infant had glaucoma. At the current examination it was noted that the eye protruded more when the baby was crying and the lids had a deep reddish appearance. A Scan revealed axial length in the right eye, 17.35 mm, and in the left eye, 17.77 mm. A macular coloboma was noted in the left eye, but the optic nerve appeared normal. Intraocular pressure was normal in each eye. Complete blood count produced normal values. ESR and clotting time were normal.

1.	The most likely diagnosis in this case is:
	a. rhabdomyosarcoma b. neuroblastoma c. lymphangioma d. capillary hemangioma e. none of the above
2.	Additional work up for this case could include:
	a. CT scan b. MRI and MRA c. patching of the right eye d. (a) and (b) e. none of the above
3.	Treatment for this condition could include:
	a. observation b. Propanolol c. intra lesional steroid d. (a), (b),and (c) e. none of the above

For answers to the above, click here on or after February 16, 2010.