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
Varices resulting from infection or trauma may get thrombosed.
Eyelid varix may present with symptoms such as
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
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.
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.
CT scan: Since most of eyelid varices may have orbital extension, a CT scan may be needed in those with orbital clinical signs.
Eyelid varices may be just observed and followed up in most of the cases.
It is possible to treat a small varix just like haemangioma with a precooled probe when applied with little pressure.
Ectatic periocular veins may be tried with sclerotherapy.
Patient with eyelid dysfunction or requiring cosmetic correction may undergo surgical excision.