Haemangioma of the orbit. Case causing periodic venous obstruction and exophthalmos treated successfully by a posteriorly placed orbital decompression.

HAEMANGIOMAS are well-known formations; they occur all over the body although they are exceedingly rare in the orbit.It is not our intention here to discuss the pathology of these neoplasms or mal- formations, as this has already been done adequately by Ewing (1940), Boyd (1947), andWillis (1948).For a comprehensive bibliography on orbital tumours and, in particular, on orbital haemangiomas, reference should be made to Reese's (1963) textbook Tumors of the Eye.Our object in reporting this case is to illustrate certain special features of these formations.Also, we have had the opportunity of observing the clinical behaviour of this particular patient over a period of eighteen years.A specially designed posteriorly placed decompression was carried out to overcome venous obstruction at the sphenoidal fissure. Case ReportA young woman aged 21 years, a dancer by profession, first came under our care in January, 1946.At that time she was complaining of drooping and swelling of the right upper eyelid and she was seeking treatment because her theatrical producer had come to the conclusion that this condition was disfiguring and, indeed, was incapacitating her for her career.At the first examination a mild degree of exophthalmos was found and slight ptosis and swelling of the upper eyelid.The movements of the eyeball were restricted to a slight degree in all directions, but not sufficient to cause diplopia.The patient gave the important information that she had had periodic attacks in which the eyeball was pushed forwards and the eyelids became so swollen that she could not open them.At this stage it was suspected that she might have an intra-orbital vascular tumour, but no thrill or pulsation could be elicited.Vision was unimpaired and the retina was normal.The radiographs of the orbit and skull were normal.There was no disease elsewhere in the body and, in particular, no birthmarks were found in the skin.At this stage it was felt that no further investigations were indicated and that it would be safest to wait for a period to see what happened.In fact, the patient returned to the clinic a few days later when the orbital condition had worsened.The clinical picture was alarming.The eye was pushed forwards, the eyelid was swollen like a red *