AU - Kahana,Alon PY - 2016/8/1 Y1 - 2016/8/1 N2 - An orbital venous varix is rare and can present with diplopia, proptosis, or hemorrhage. [experts.umich.edu]

Presentation Presented to the emergency department with chief complaint of bilateral, left greater than right, eye swelling and pain since she woke up in the morning. The pain was worse with lateral and medial gaze. [radiopaedia.org]

We report the case of a 71-year-old male who presented with the acute onset of a cystic mass below the right inner canthus and associated vertical diplopia. [jhu.pure.elsevier.com]

• Collapse

  Without provocative examination ( Valsalva maneuver ) they can be very difficult or impossible to diagnose, as the varix may completely collapse. [radiopaedia.org]

  Being that the area of the applanation surface is fixed, EVP can be determined by the force required to collapse the vessel. [19] Air Jet. [eyewiki.org]

• Soft Tissue Mass

  A CT scan of the orbits demonstrated a serpiginous soft tissue mass within the superior portion of the right orbit, consistent with a thrombosed orbital varix. Conservative management was agreed with prism glasses and ophthalmological follow-up. [ncbi.nlm.nih.gov]

  A magnetic resonance imaging (MRI) scan showed a serpiginous superior orbital mass having a vascular communication to the subcutaneous soft tissue mass on the temple ( Figure 1 ). [nature.com]

  Fine cut contrast-enhanced CT scans usually show ill-defined, heterogeneous multiloculated enhancing soft tissue mass(es) with connections to the orbital and extraorbital circulation. [surgicalneurologyint.com]

  Palpate the orbital rim, soft tissues, masses (note location, shape and size). Check for a globe pulsation or thrill (with the bell of the stethoscope over the closed eye). Check eye movements. [patient.info]

• Enophthalmos

  We report a case of pulsating enophthalmos secondary to orbital varix associated with orbital bony defects. A 64-year-old female with pulsating enophthalmos of the right eye was found to have a right orbital mass with bony defects of the orbit. [ncbi.nlm.nih.gov]

  A 64-year-old female with pulsating enophthalmos of the right eye was found to have a right orbital mass with bony defects of the orbit. Valsalva maneuver failed to induce proptosis. [digital.library.adelaide.edu.au]

  The left eye showed a distinct enophthalmos with slight widening of the palpebral aperture as compared with the right eye. The superior palpebral furrow was very deep [Figure - 1]. [ijo.in]

  Vadlamudi V...Kahana A 2015 8 Orbital Varix Thrombosis and Review of Orbital Vascular Anomalies in Blue Rubber Bleb Nevus Syndrome. ( 24879057 ) Shams P.N....Selva D. 2014 9 Dynamic MRI of an Orbital Varix. ( 25271831 ) Magrath G.N....Proctor C.M. 2014 10 [Enophthalmos [malacards.org]

• Unilateral Proptosis

  Orbital varix thrombosis: a rare cause of unilateral proptosis Summary Orbital varices are thin walled, low flow, distensible veins which may rarely present with periorbital pain, proptosis or visual loss. [casereports.bmj.com]

  A patient presented with unilateral proptosis which was compressible and increases on bending forward. No thrill or bruit was present. MRI shows a retroorbital mass with enhancement. [pgblazer.com]

  proptosis. ( 23355578 ) 2013 13 Optic neuropathy following endovascular coiling of an orbital varix. ( 22571224 ) 2012 14 Proptosis caused by partially thrombosed orbital varix of the superior orbital vein associated with traumatic carotid-cavernous [malacards.org]

  Orbital varix thrombosis: a rare cause of unilateral proptosis. BMJ Case Rep 2013 Jan;:2013. Foroozan R, Shields CL, Shields JA, et al. Congenital orbital varices causing extreme neonatal proptosis. Am J Ophthalmol 2000;129:693–694. [synapse.koreamed.org]

• Blepharospasm

  The clinical signs in touch with the uncomplicated orbital varix veins are few mainly intermittent and positional exophthalmitis, often painful, or a blepharospasm. [panafrican-med-journal.com]

• Cutaneous Manifestation

  A 57-year-old woman with cutaneous manifestations of (BRBNS) presented with acute left proptosis and venous congestion secondary to thrombosis within a superior ophthalmic vein varix. [ncbi.nlm.nih.gov]

Diagnosis, Workup and Treatment The presentation of painless proptosis in a teenager can represent infectious, inflammatory or neoplastic processes. [reviewofophthalmology.com]

[…] this workup is completed and negative may the patient be considered to have idiopathic elevated EVP. [eyewiki.org]

Laboratory workup was negative aside from positive toxoplasma IgG antibodies. [cureus.com]

Because orbital varix treatment is the treatment of a rare vascular orbital tumor disease, chances are that only a few doctors like Dr. Debraj Shome at The Esthetic Clinics will be available with experience in orbital varix treatment. [oculoplastic-eyelid-orbit-surgery.com]

Treatment can be challenging, especially if the varix is in a posterior location within the orbit, since surgical exposure becomes difficult. [experts.umich.edu]

Active treatment of orbital varix may, therefore, be important, and development of a suitable form of treatment is desirable. [ijo.in]

Treatment of intraorbital AVFs remains controversial. [surgicalneurologyint.com]

The etiology of this unusual clinical manifestation and the treatment of the patient are briefly discussed. [ncbi.nlm.nih.gov]

[…] hypointense c.f. extraocular muscles If thrombosis is present the imaging is more variable: T1: heterogeneous with areas of high signal (see aging of blood on MRI ) T2: heterogeneous with areas of high signal (see aging of blood on MRI ) Treatment and prognosis [radiopaedia.org]

Prognosis is very poor. Metastases : In children the orbit may be the site of secondary deposits from neuroblastoma or acute leukaemia. [patient.info]

The patient had sustained facial trauma two years previously and a post-traumatic etiology is postulated. [jhu.pure.elsevier.com]

The etiology of this unusual clinical manifestation and the treatment of the patient are briefly discussed. [ncbi.nlm.nih.gov]

Courtesy of Michael Migliori, MD Etiology Orbital varices are venous malformations of the orbit, vascular hamartomas. [1] [2] They consist of a plexus of thin-walled distensible low flow vein-like vessels that are commonly intrinsic to the normal circulation [eyewiki.aao.org]

Michael Migliori, MD Etiology Orbital varices are venous malformations of the orbit, vascular hamartomas. [1] [2] They consist of a plexus of thin-walled distensible low flow vein-like vessels that are commonly intrinsic to the normal circulation. [3] Epidemiology [eyewiki.aao.org]

Epidemiology: Orbital varix, being a very uncommon condition, constitutes for approximately 1.3% of all orbital tumours. [oculoplastic-eyelid-orbit-surgery.com]

The clinical, radiographic, surgical, and histopathologic features of this entity are described and discussed and a hypothesis is proposed to explain the pathophysiology of orbital varix thrombosis. [ncbi.nlm.nih.gov]

The pathophysiology of these latter headaches could be related to congestion and dilation of cerebral venous sinuses and large veins [ 6 ]. We present a postural headache related to an orbital varix. [jneuro.com]

An analysis of thirty cases of orbital lymphangioma: pathophysiologic considerations and management recommendations. Ophthalmology 1990; 97 : 1583–1592. 4. Suzuki Y, Obana A, Gohto Y, Miki T, Otuka H, Inoue Y. [nature.com]

In Diseases of the Orbit: Pathophysiologic Patterns of Orbital Disease, Anatomic Patterns of Orbital Disease, Pathophysiologic Approach to Clinical Analysis of Orbital Disease, Investigation of Orbital Disease and its Effect on Function. J.B. [csops.com]

Pathophysiologic considerations and management recommendations. Ophthalmology 1990 ; 97 : 1583 –92. ↵ Weill A, Cognard C, Castaings L, et al. Embolization of an orbital varix after surgical exposure. Am J Neuroradiol 1998 ; 19 : 921 –3. [bjo.bmj.com]

Patient care Bleeding esophageal varices constitute a medical emergency, requiring immediate treatment to control hemorrhage and prevent hypovolemic shock. [medical-dictionary.thefreedictionary.com]

Therefore, primary- prevention of the first episode of bleeding is very important. Varice Carl is on Facebook. Arterio- venoase cerebrale anevrisme localizate la nivelul arterelor. [xuyysafurokawek.gq]

For now, selenium supplements are not recommended as a preventive measure for prostate cancer. -- Adapted from the Mayo Clinic Health Letter ----------- Medical Edge from Mayo Clinic is an educational resource and doesn't replace regular medical care. [articles.chicagotribune.com]

She was started on prednisone 20 mg twice daily as well as erythromycin ointment and artificial tears to prevent exposure keratopathy. [reviewofophthalmology.com]

[…] authors recommend sclerotomies with filtering surgery. [4] [22] Laser trabeculoplasty has shown not to be beneficial. [3] One case report recommends performing a "tight" trabeculectomy with multiple releasable sutures to titrate the IOP gradually and prevent [eyewiki.org]