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ARTICLE
Year : 1966  |  Volume : 14  |  Issue : 2  |  Page : 91-93

Haemangioma of the orbit


Government Medical College, Patiala, Punjab, India

Date of Web Publication12-Jan-2008

Correspondence Address:
Dhanwant Singh
Government Medical College, Patiala, Punjab
India
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Source of Support: None, Conflict of Interest: None


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How to cite this article:
Singh D. Haemangioma of the orbit. Indian J Ophthalmol 1966;14:91-3

How to cite this URL:
Singh D. Haemangioma of the orbit. Indian J Ophthalmol [serial online] 1966 [cited 2020 Feb 23];14:91-3. Available from: http://www.ijo.in/text.asp?1966/14/2/91/38571

In large series of cases of orbital tumour producing exophthalmos such as those of Reese (1941), Forrest (1949) and Drescher and Bendict (1950), haemangioma is the tumour commonly found. Reese found 25 of a series of 109 orbital tumours to be of this type, Forrest 25 of 184, Drescher and Ben­dicts seventeen in a total of 177. Diag­nosis of these tumours has usually rested on clinical features of orbital and ocular disturbances assisted in some cases by the presence of other vascular abnormalities, commonly cu­taneous haemangiomata.

The following case is being reported because, the manner in which it pre­sented is of interest and because of the relative infrequency of this tumour as compared to others' series.

The case was unassociated with any visual disturbance. As emphasised by Walsh (1957) and was detailed by Birschherschfield (1930) in the well ­known series of 92 cases, in 21 all vision had been lost in the affected eye and in 39 a more or less serious defect remained. Exposure keratitis, corneal ulceration from severe proptosis and optic or retinal atrophy from direct pressure or following papilloedema are responsible for visual loss. Unexplained amblyopia appears in an apprecia­ble proportion of cases (Duke Elder, 1952):

In the case presented, there was no visual disturbance nor any change in the fundus, inspite of proptosis and tumour tissue encircling and pressing on the lower inner and outer sides of the optic nerve.

The limitation of movements of eye though slight were early to appear. It is important to note that the mobility of the globe remains unimpaired for a long time (Reese).

In this hospital, 33 cases of propto­sis were treated by the department in the last live years, and only two cases lone more in addition to the present case) were found to be of haemangioma orbit (6 per cent) which percentage is much less than the series mentioned already.


  Case Report Top


Patient Prem Kaur aged 9 years was admitted in November, 1963, with gradually increasing proptosis of the right eye for the last 1½ years, though the parents had noted the prominence of the right eye much earlier. The proptosis was unaccompanied by dis­turbances of vision, pain, diplopia, headache, vomiting, palpitation, loss of weight. There was no history of sud­den increase in proptosis or increase on bending of the head coughing, sneezing or crying.


  Examination Top


No evidence of cutaneous haeman­gioma or prominence of blood vessels seen on the face or elsewhere. Pulse and temperature and blood pressure were within normal limits. Thyroid was not enlarged. Neurological and E.N.T. examinations were normal.


  Local Examination Top


Left eye was normal.

Right eye: There was a forward proptosis of 8 mm. [Figure - 1],[Figure - 2]. The globe was slightly compressible on pressure. The orbital tension was not felt to be very high on digital palpa­tion.

There was no bruit or thrill.

No mass was palpable on trying to pass a finger between the globe and orbital margin.

Movements were slightly limited all around. Lids: There was no evidence of any haemangioma.

The cornea, pupillary reactions, the intra ocular tension, fundus and vision were normal.


  Investigations Top


Routine blood, urine and stool ex­aminations were normal.

Bone marrow showed an undisturbed M.E. ratio, with normoblastic reaction.

V.D.R.L. and Kahn test were nega­tive. Casoni's test was negative. B.M.R. was normal.

Skiagrams of the skull, sinuses orbit and optic formaina were normal.


  Operation Top


The orbit was explored through an­terior orbitotony under general anaes­thesia by external canthotomy and cutting the conjunctiva along upper and lower outer halves of the fornices.

The tumour was seen in the muscle cone with a tendency to protrude through the gap between lateral rectus and inferior rectus.

The tumour was partly encapsulated and contained bluish cysts containing haemorrhagic fluid. The tumour was se­parated and excised by blunt dissection and its deeper end was seen to extend upto the apex, encircling the outer, lower and inner sides of the optic nerve.


  Histopathology Top


The tumour was found to be haemangioma.


  Post Operative Top


The recovery was uneventful. The bandage was removed on the ninth day. The proptosis disappeared and on the 15th day of the operation there was slight enophthalmos of the R.E. and slight limitation of movements upwards and inwards [Figure - 3]. The vi­sion and fundus were normal. Follow up for 9 months showed no change in the pictures.[4]


  Summary Top


A case of haemangioma of orbit is described, leading to proptosis without any loss of vision. It was operated successfully with uneventful recovery.

 
  References Top

1.
Birch Hirschfeld (1930). quoted by H. E. Hobbs, Brit. J. of Ophthal. (1961) 45, 231.  Back to cited text no. 1
    
2.
Walsch, F. B. (1957). Clinical Neuro­ophthalmology, 2nd Ed. 1955, Williams and Wilkins. Baltimore.  Back to cited text no. 2
    
3.
Duke-Elder. S. (1952). Text book of Ophthal­mology. vol. 5, p. 5666. Kimpton London.  Back to cited text no. 3
    
4.
Algernon B. Reese (1953), Tumours of Eye. p. 350, haul, B. Hoeber, Inc.  Back to cited text no. 4
    


    Figures

  [Figure - 1], [Figure - 2], [Figure - 3]



 

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  In this article
Case Report
Examination
Local Examination
Investigations
Operation
Histopathology
Post Operative
Summary
References
Article Figures

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