ORBITAL VARIX

It is an uncommon vascular malformation that is composed of enlarged single or multiple tubular venous channels within the orbit with direct communication to the systemic venous system.

Orbital venous varices are divided into primary and secondary.

Primary orbital varices are idiopathic and most likely congenital. They are confined to the orbit.

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 which drain via the orbit .Secondary orbital varices also occur in association with vein of Galen aneurysmal malformations and occasionally with venous angiomas.

It presents with intermittent proptosis which increases with straining, crying or stooping.

Orbital varix is usually diagnosed between the ages of 10 to 30 years. However, it may be seen in any age group, including neonates. Varix usually affects superior ophthalmic vein. Other veins of the orbit may also be involved.

Clinical features:

• Orbital varix is usually unilateral, vascular malformation (commonly venous in origin).
• positional proptosis with a head-down position, and intermittent proptosis that is exacerbated by coughing, straining.
• non-pulsatile, intermittent axial proptosis which is not associated with bruit.
• prominent conjunctival vessels
• vascular lesions of eyelids or conjunctiva, and may be of arterial or venous origin.
• enophthalmos due to fat atrophy.
• occasional bruising.

Diagnosis :

Investigations

• X-ray:Any evidence of calcification due to phlebolith.
• CT Imaging: orbital varix has globular or smooth fusiform appearance, which enhances strongly with contrast medium..
• MRI Imaging:
• ultrasonography:There is increased size of the lesion on ultrasonography.
• Venography:This may demonstrate abnormal saccular vessels flowing out through venous channels.
• Colour Doppler Imaging:This may be used to demonstrate an orbital varix. This is a non-invasive method of investigation.

HOMOEOPATHIC MANAGEMENT:

ARNICA MONTANA

 Varicosity with  extreme soreness and bruised feeling. Bruised feeling all through the body as if beaten.   swollen, red, and hot.

AMBRA GRISEA

Varicose veins of left eye. Painful. During menstruation, increased swelling of varicose veins, with pressure in the legs

CALCAREA FLOURICA

Enlarged, hard varicose veins. Varicose veins are knotted. Veins dilate, and become varicose inflamed.

CARBO VEGETABILIS

Varicose easily bleeding Varicose veins during pregnancy.  

FLUORIC ACID

Varicose veins, especially chronic. Varicose veins tending to ulceration. Painful varicose veins, worse from warmth

HAMAMELIS VIRGINIANA

MILLIFOLIUM

PULSATILLA NIGRICANS

VIPERA