Thrombosed varix of the superior ophthalmic vein causing unilateral proptosis

Dr Chinh Nguyen1, A/Prof  Nitin Verma1

1Royal Hobart Hospital , Hobart, Australia

78 year-old female presented with proptosis, lid chemosis and diplopia on the right eye. The patient never had a history of head trauma or any other significant trauma. Magnetic resonance imaging angiography showed a thrombosed varix of the superior ophthalmic vein, with no evidence of dural arteriovenous fistula or vascular malformation. Digital subtraction angiography (DSA) was performed one week following the initial presentation, and in the mean time the patient was admitted for observation without anticoagulation. DSA found the thrombosed varix to have re-vascularised on its own at day seven of admission. All symptoms subsided after 2 weeks of the intial presentation. This case study demonstrated that an isolated thrombosed varix of an ophthalmic vein may resolve on it’s own, without the need for anticoagulation or surgery.