|Year : 1990 | Volume
| Issue : 1 | Page : 36-37
Rajaji Hospital, Madurai, India
Saraswathy Eye Clinic, East VE Madurai - 625 001
Source of Support: None, Conflict of Interest: None
An unique case of Orbilot varix, followed up for five years, developed phleboliths. Venography and operated specimen of the phleboliths is presented.
|How to cite this article:|
Baskararajan G. Orbital phleboliths. Indian J Ophthalmol 1990;38:36-7
| Introduction|| |
Phleboliths are intravascular calcification predisposed by slowing of circulation within passive venous channels. Such slowing of circulation can occur in venous varicocities of the orbit . Occasionally phleboliths within the tumour are visible radiographically, the formation of which is due to the stagnation of blood in the vascular spaces in the tumour. However, the presence of phleboliths implies venous stagnation and they may change their position with the altered position of the proptosed eye.in long standing varices this is a possibility. Though I have seen six cases of orbital varices leading to intermittent proptosis, phlebolith was noted in only one case and the operated specimen is reported in this case. This is probably the first operated specimen of phlebolith in the orbit to be reported in the literature.
| Case report|| |
Mrs. S aged 41 years came with multiple swellings around the left orbit. These swellings became more prominent along with intermittent proptosis during Valsalva maneuver. Orbital venography , performed by percutaneous puncture demonstrated multiple sites of pooling of dye and decalcified areas over the frontal bone [Figure - 1] She was not willing for surgical intervention. Five years later, the same patient turned up with multiple peanut sized hard masses in the swelling present on the lower lid [Figure - 2]. Plain X-Ray revealed multiple calcified spots in the corresponding area [Figure - 3]. Surgical excision of the mass followed by ligation of the feeder vascular channels was performed. The mass contained several phleboliths of varying size [Figure - 4]. Histopathological examination showed a central area of thrombosis with concentric deposition of calcium. The superficial layers of the phlebolith were carefully removed. They came off like onion peelings. The phleboliths were ground thoroughly and chemical analysis of the powdered material revealed the presence of calcium and phosphates.
| Discussion|| |
Slowing of circulation and recurrent stagnation of blood within venous-varicosities promote intravascularthrombosis . Calcium gets deposited over such a thrombotic mass leading to phlebolith formation. It takes several years for the process to occur.
| Conclusion|| |
A rare specimen of orbital phlebolith is presented probably for the first time in literature.
| Acknowledgement|| |
I thank the Dean, Madurai Medical College for the permission to publish this material.
| References|| |
Jain and Srivastava. Orbital varicocele. Brit. J. Ophthal., 55, 505, 1971.
Baskararajan. Orbital venography, Jl of Madras State Ophthalmic Association, 15:81, 1978.
Baskararajan, Thiruvenkatasamy, Jeykumar, Dorairaj, Sowmini Ramesh and Visvanathan. Idiopathic superior ophthalmic vein thrombosis. Jl.of Indian Paediatrics 18,74-75, 1981.
Duke-Elder (EDR) System of Ophthalmology, 13, Part II pp. 811;817:819 Henry Kempton, London 1974.
[Figure - 1], [Figure - 2], [Figure - 3], [Figure - 4]