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Pulsating enophthalmos in association with an orbital varix.

Prabhakaran VC, Selva D - Indian J Ophthalmol (2009 May-Jun)

Bottom Line: 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.Proptosis induced by general anesthesia and positive pressure ventilation suggests an underlying distensible venous anomaly.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology and Visual Sciences, University of Adelaide, Adelaide, Australia. eye@health.sa.gov.au

ABSTRACT
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. Valsalva maneuver failed to induce proptosis. The diagnosis of orbital varix was confirmed by exploratory orbitotomy. During general anesthesia for orbitotomy, proptosis of the right eye was noted. Ophthalmologists should be aware of the association between orbital varices and cranial bony defects and encephaloceles. Proptosis induced by general anesthesia and positive pressure ventilation suggests an underlying distensible venous anomaly.

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T2-weighted MRI scan reveals an intensely enhancing irregular mass lesion in the inferior orbit within which several flow voids can be observed (arrow)
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Figure 0005: T2-weighted MRI scan reveals an intensely enhancing irregular mass lesion in the inferior orbit within which several flow voids can be observed (arrow)

Mentions: Computed tomographic scan showed a diffuse, moderately enhancing mass in the right inferior orbit. Large bony defects were noted in the medial wall and greater wing of sphenoid on the right side [Fig. 2a]. There was no change in the size of the orbital mass between axial and coronal scans.[3] Magnetic resonance imaging (MRI) scans revealed an intensely enhancing, irregular mass filling the right inferior orbit, with flow voids [Fig. 2b]. These features were suggestive, but not confirmatory, of varices or vascular malformation. A neurosurgery consultation suggested observation for the orbital bony defect.


Pulsating enophthalmos in association with an orbital varix.

Prabhakaran VC, Selva D - Indian J Ophthalmol (2009 May-Jun)

T2-weighted MRI scan reveals an intensely enhancing irregular mass lesion in the inferior orbit within which several flow voids can be observed (arrow)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2683432&req=5

Figure 0005: T2-weighted MRI scan reveals an intensely enhancing irregular mass lesion in the inferior orbit within which several flow voids can be observed (arrow)
Mentions: Computed tomographic scan showed a diffuse, moderately enhancing mass in the right inferior orbit. Large bony defects were noted in the medial wall and greater wing of sphenoid on the right side [Fig. 2a]. There was no change in the size of the orbital mass between axial and coronal scans.[3] Magnetic resonance imaging (MRI) scans revealed an intensely enhancing, irregular mass filling the right inferior orbit, with flow voids [Fig. 2b]. These features were suggestive, but not confirmatory, of varices or vascular malformation. A neurosurgery consultation suggested observation for the orbital bony defect.

Bottom Line: 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.Proptosis induced by general anesthesia and positive pressure ventilation suggests an underlying distensible venous anomaly.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology and Visual Sciences, University of Adelaide, Adelaide, Australia. eye@health.sa.gov.au

ABSTRACT
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. Valsalva maneuver failed to induce proptosis. The diagnosis of orbital varix was confirmed by exploratory orbitotomy. During general anesthesia for orbitotomy, proptosis of the right eye was noted. Ophthalmologists should be aware of the association between orbital varices and cranial bony defects and encephaloceles. Proptosis induced by general anesthesia and positive pressure ventilation suggests an underlying distensible venous anomaly.

Show MeSH
Related in: MedlinePlus