Orbital varices are uncommon lesions that usually are caused by congenital venous malformations and that are manifested by intermittent proptosis induced by changes in venous pressure. Maneuvers such as coughing, straining, forced expiration, bending forward, and Valsalva's maneuver can accentuate an orbital varix, which then can be confirmed by radiologic studies. Scanning techniques with Valsalva's maneuver can illustrate enlargement of the varix to confirm the diagnosis.1
We describe a yoga instructor who presented with complaints of unilateral intermittent proptosis and whose magnetic resonance imaging (MRI) scan illustrated an indeterminate unilateral lesion. The computed tomographic (CT) scan with Valsalva's maneuver demonstrated enlargement of an orbital varix on both the symptomatic and the opposite side.
Report of a Case.
A 62-year-old woman in excellent health had a 4-day history of intermittent, painless proptosis, which was accentuated when she bent forward. She had no visual complaints. Symptoms started about 1 year previously,
Cohen JA, Char DH, Norman D. Bilateral Orbital Varices Associated With Habitual Bending. Arch Ophthalmol. 1995;113(11):1360-1362. doi:10.1001/archopht.1995.01100110020011