Sclerotherapy of the Visible Surface of the Eye: A Case Series of Two Patients

Two patients with vascular malformations, 1 venous malformation (VM) and lymphatic malformation (LM), with bulky involvement of the visible surface of the eye (bulbar conjunctiva), recently presented for treatment. Direct puncture bleomycin sclerotherapy in this delicate location is a novel approach in our practice, and, finding minimal guidance in the literature regarding safety and efficacy, we felt it important to present our experience. The VM was treated in 6 sessions. This led to improved eye movement and markedly decreased volume. The LM underwent 3 sclerotherapy procedures. Clinically, the patient’s near-continuous eye-watering ceased, and reduced conjunctival swelling was noted. Neither experienced major complications, eye injury, or visual impairment. Direct puncture bleomycin sclerotherapy achieved symptom relief, improved cosmesis, and reduced lesion size in these 2 patients with minor, transient complications. Within the limitations of this small case series, this approach appears promising for slow-flow vascular malformations involving the surface of the eye.