Cavernous Haemangioma

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Clinical Presentation

  • Most common benign orbital tumor in adults
  • Typically affects middle-aged women, potential progression during pregnancy
  • Slowly progressive painless unilateral proptosis
    • Associated with optic disc oedema, choroidal folds
    • +/- induced hyperopia
    • Usually intraconal
  • Motility disorders
  • Elevated intraocular pressure possible

Work-up

  • Visual acuity, Hertel exophthalmometer, motility, colour/contrast vision, RAPD?, intraocular pressure, fundus examination
  • MRI/CT of orbit with contrast: well-defined, slow contrast uptake
  • Ultrasound: high reflectivity in A-scan

Treatment

  • Observation
  • Surgical removal in toto (if symptomatic)

Sources

  • EyeWiki Orbital cavernous venous malformation (cavernous hemangioma)
  • Review of Ophthalmology: Neil J. Friedman; Peter K. Kaiser; William B. Trattler; Elsevier, 3rd Edition (2018)
  • The Wills Eye Manual: Office and Emergency Room Diagnosis and Treatment of Eye Disease; Kalla Gervasio MD, Travis Peck MD et al; Lippincott Williams&Wilkins; 8th Edition (2021)
  • Kanski‚Äôs Clinical Ophthalmology: A Systematic Approach; John E Salmon MD; Elsevier; 9th Edition (2019)