What is Eyelid Varix ? |
Eyelid Varix is an abnormal dilatation of one or more normal blood vessels. Varices of the eyelids are usually an extension forward of the orbital varices into the eyelid. These probably are congenital or acquired weakness of the affected vein, or to an obstruction of the venous circulation.
Varices may result due to
- An arteriovenous malformation
- Compression by an arterial aneurysm or a tumour
- Infection
- Trauma involving wall or lumen, of the vein
Varices resulting from infection or trauma may get thrombosed.
Eyelid Varix Symptoms |
- Soft brown or blue lesion which increases with increase in venous pressure
- Organised thrombus may show haemosiderin and calcification
- Ruptured varix may show haemorrhage and lid ecchymosis
- Haemorrhage in deep associated orbital varix may present with acute pain, proptosis and restriction of ocular movements.
Eyelid Varix Causes |
Eyelid varix is caused probably due to congenital or acquired weakness of the involved vein, or due to obstruction of the venous circulation.
Eyelid varices may result due to
- An arteriovenous malformation
- Compression by an arterial aneurysm or a tumour
- Infection
- Trauma involving wall or lumen of the vein
Eyelid Varix Diagnosis |
Diagnosis of eyelid varix is clinical.
Eyelid varix is a well defined soft dark blue or brown lesion without any associated palpable thrill or bruit. The lesion increases in size with any activity which raises venous pressure such as Valsalva manoeuvre.
Some cases with organised thrombus may be associated with haemosiderin deposition or dystrophic calcification. The lesion is firm in consistency and less compressible in thrombosed lesions. Varices may get ruptured with minor trauma, resulting in haemorrhage and lid ecchymosis.
In cases with orbital extension, deep haemorrhage may result in onset of acute pain, proptosis and restriction of ocular movements.
Pathology
Grossly, eyelid varix lies anterior to septum. Deep orbital varix may produce proptosis.
Microscopically, varix shows dilated vascular channels, filled with clotted blood and focal thrombosis. There may be phlebolith formation.
Investigations
CT scan: Since most of eyelid varices may have orbital extension, a CT scan may be needed in those with orbital clinical signs.
Differential diagnosis
It includes
- Capillary haemangioma
- Cavernous haemangioma
- Arteriovenous malformation
- Lymphangioma
- Dacryocele