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Primary orbital varices
Medical expert of the article
Last reviewed: 04.07.2025
Primary varicose veins consist of weakened segments of the venous system of the orbit of varying length and complexity. Participating in the blood flow, varicose veins enlarge with an increase in venous pressure. Their elastic properties depend on the residual thickness and elasticity of the walls. In most cases, the disease is unilateral and is located in the superonasal region. CT and planar radiographs detect phleboliths in 20% of cases. The age of initial manifestations ranges from childhood to late middle age.
[ Symptoms of primary orbital varicose veins
- intermittent exophthalmos without external signs. Exophthalmos is not pulsating and without accompanying noise. Since the orbital veins do not contain valves, reversible exophthalmos can quickly subside or increase with an increase in venous pressure during coughing, straining, Valsalva maneuver, with a forced body position or external compression of the jugular veins. With prolonged disease, atrophy of the surrounding fatty tissue and anophthalmos with a deepening of the superior palpebral-orbital fold, visible in the supine position and returning to normal with an increase in venous pressure, can develop;
- visible changes in the eyelids, especially on the conjunctiva side, which increase with the Valsalva test;
- a combination of visible changes and exophthalmos (most common).
Complications of primary orbital varicose veins include acute hemorrhage and thrombosis.
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Treatment of primary orbital varicose veins
Treatment of primary orbital varicose veins by surgical removal is technically difficult due to the fragility of the formation and bleeding. Indications are recurrent thrombosis, pain, pronounced exophthalmos and optic nerve glorification.