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This 4-month-old child was noted by the parents to have just a slightly reddish/purple hue to the skin around the right eye at birth. They now note this appearance that has gradually developed.

1.	This lesion is most likely caused by:
	d -- abnormal blood vessel growth This lesion is caused by abnormal blood vessel growth.
2.	The most likely diagnosis is:
	a -- capillary hemangioma The most likely diagnosis is capillary hemangioma.
3.	Management of this patient could include:
	e -- (a), (b), and (c) Capillary hemangioma tends to be a self-limiting condition with the lesion clearing in months to years to a point where it is either not noticeable or a relatively minor problem.  It is in the patient’s and the family's best interest to be sure that the “cure” is not worse than the disease.  In this case, simply observing is a good choice.  Steroid treatment can have complications and surgery is definitely contraindicated in a case like this.  Infants with hemangioma should be watched carefully for amblyopia resulting from induced astigmatism or occlusion. The induced astigmatism can be discovered with retinoscopy which should be done at each return visit.  When the lesion is such that amblyopia is a concern, treatment should be undertaken.  In a case like this, systemic or topical steroids could be tried and a newer technique, systemic  Propranolol  treatment, could be used.