Orbital varix

Title

Other Names:

Orbital venous varix

Categories:

Eye diseases

Summary Summary

An orbital varix is an abnormally enlarged, thin walled vein that is in direct communication with the normal orbital vessels. Orbital varices can be primary (most likely present from birth and confined to the orbit) or secondary (acquired due to increased blood flow in association with additional venous malformations elsewhere in the body). Symptoms such as intermittent double vision (diplopia) or bulging eyes (proptosis), pain and/or orbital bleeding (hemorrhage) may be brought on by stooping, bending, coughing or straining. Small lesions are managed through observation. Larger lesions may require surgery.^[1]^[2]^[3]

Last updated: 7/17/2012

Treatment Treatment

Most people with orbital varices experience little too few symptoms and require no treatment.^[4] Occasionally progressive eye pain, eye bulging, compression of the optic nerve, vision loss and/or disfigurement develops and prompts treatment.^[4]^[5]^[6]

There are no well established guidelines for treatment. Treatment is individually tailored to the patient. People seeking treatment for obital varices benefit from a consultation with a team of doctors, such as an opthalmologist, neurosurgeon, and/or neurointerventional radiologist.^[4]^[5] Treatment with electrothrombosis (the use of an electrical current to block blood flow to the varix),^[5] stereotactic gamma knife radiosurgery^[4], sclerotherapy, surgical resection, and embolization (blocking of blood flow through the varix) with cyanoacrylate glue followed by excision have been described in the medical literature.^[5]

Last updated: 1/11/2013

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References References

N Islam, K Mireskandari, GE Rose . Orbital varices and orbital wall defects. Br J Ophthalmol. June 2004; http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1772180/?tool=pubmed. Accessed 7/17/2012.
MN Neiberg. An unusual presentation of a lid varix. Optometry. May 2009; http://www.ncbi.nlm.nih.gov/pubmed/19410226. Accessed 7/17/2012.
F Gaillard et al.. Orbital venous varix. Radiopaedia.org. 2012; http://radiopaedia.org/articles/orbital-venous-varix. Accessed 7/17/2012.
Xu D, Liu D, Zhang Z, Zhang Y, Song G. Gamma knife radiosurgery for primary orbital varices: a preliminary report. Br J Ophthalmol. 2011 Sep;95(9):1264-7; http://www.ncbi.nlm.nih.gov/pubmed/20971792. Accessed 1/10/2013.
Couch SM, Garrity JA, Cameron JD, Cloft HJ. Embolization of orbital varices with N-butyl cyanoacrylate as an aid in surgical excision: results of 4 cases with histopathologic examination. Am J Ophthalmol. 2009 Oct;148(4):614-618.e1; http://www.ncbi.nlm.nih.gov/pubmed/19541289. Accessed 1/10/2013.
Tsai AS, Fong KS, Lim W, Al Jajeh I, Chuah CT, Rootman J. Bilateral orbital varices: an approach to management. Ophthal Plast Reconstr Surg. 2008 Nov-Dec;24(6):486-8; http://www.ncbi.nlm.nih.gov/pubmed/19033851. Accessed 1/10/2013.