![]() They may also become acutely symptomatic if they thrombose. Orbital venous varices are the most common causes of intraorbital hemorrhage. Presentation may also be due to a complication. The protracted distension can actually create more room for the globe to fall back into when not distended leading to paradoxical enophthalmos when at rest 1. Typically these lesions present due to intermittent diplopia or proptosis during episodes of straining or prone/stooping positioning 1-3. There is a reported association with venous anomalies intracranially which may or may not directly communicate with the varix 1. Cases have however been reported at essentially any age 2. Although it is believed to be congenital, and thus present at birth, patients typically do not become symptomatic until later childhood or early adulthood (10-30 years of age). Orbital varix is a rare entity, accounting for less than 1.3% of all orbital tumors 2. The remainder of this article concerns itself with primary orbital venous varices. There may be isolated segmental saccular or fusiform dilatation of the cortical veins. Secondary orbital varices also occur in association with vein of Galen aneurysmal malformations and occasionally with venous angiomas. ![]() Secondary orbital venous varices are those that are acquired due to increased blood flow (as a result of intracranial arteriovenous malformations, caroticocavernous fistula, dural arteriovenous fistula, etc.) which drain via the orbit 2,4. ![]() Primary orbital varices are idiopathic and most likely congenital. Orbital venous varices are divided into primary and secondary. ![]()
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