To the Editor.
—I read with interest the article by Bogan and colleagues.1 The observation that dacryocele, as well as hemangioma, may cause high degrees of astigmatism was appropriately stressed in the article. However, I very much doubt the authors' conclusion that "patients with dacryoceles may, therefore, have a risk of anisometropic amblyopia at least comparable with that of patients with hemangiomas." While this may be true in untreated cases, the authors' data clearly showed that, in their cases, dacryocele uniformly resolved with treatment, whereas the results of treatment of adnexal hemangioma were more variable. In their series of 17 patients with hemangioma, there were four cases of persistent tumor and another four cases had incomplete follow-up data. Of the remaining nine cases of hemangioma, only one resolved before the patient was 6 months of age. Twelve patients (70.6%) had documented evidence of amblyopia. This contrasts with the group
Reifler DM. Astigmatism Associated With Adnexal Masses in Infancy. Arch Ophthalmol. 1988;106(4):448. doi:10.1001/archopht.1988.01060130490009