Bilateral orbital varices: Report of a patient presenting with thrombosis of an inferior nasal varix

Orbital varices are rare venous anomalies that usually produce a unique clinical picture of intermittent proptosis associated with dependency of the head, jugular vein compression, the Valsalva maneuver, and other mechanisms elevating ocular venous pressure. 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. Subsequent radiologic and histopathologic evaluation revealed a thrombosed, prolapsed varix with underlying bilateral orbital varices. The patient had sustained facial trauma two years previously and a post-traumatic etiology is postulated. The patient's clinical, physical and radiologic findings are discussed, and the characteristic features of orbital varices are reviewed.