Orbital varices,sunken eye,painful
is there anything we can do to help alleviate the symptoms , and why has it happened ?
Orbital Varices if painful can be helped by Ice compresses.
Pack ice cubes in a cloth and put over the varices for 5 minutes every 4 hours and she should find it as a good relief. If there is fever and headache, a Ibuprofen preparation can be helpful too.
Next thing is we have to find out the reason for varices, rarely there is any systemic disease. I would like to know if she has any other associated symptoms like
2) Proptosis ( protruding Eye ball)
3) Intermittent fever
4) Neck pain on flexion
5) Since when does she have them, was it a sudden development?
6) Thyroid hormone status
7) Vision status is important
Please get her examined by a primary care, if not an ophthalmologist, to check for basic reasons for Orbital varices. He can provide better painkillers if my above quick home work does not help.
Let me know if I can help you with more answers.
She has had a CT scan and a MRI and we were advised to leave wee alone unless there were significant changes
Congenital varices have no clinical significance with clear CT / MRI images.
My advice above with ice compresses should help you, Ibuprofen etc have you done it? There are no clear facts to say what sparks these pains. Simple stress and migraine are known but illdefined reasons.
Hope it helps.
Your Ophthalmologist did the right test to do find the Orbital Varices. I am not commenting on his acumen. What I mean to say is, the definitive treatment cannot be started when there are no secondary causes. Congenital varices are looked as venous hamartomas (unknown enlargement of veins).
The Ophthalmologist would have educated you that a slow, painless enlargement can happen over years. Sometimes acute episode of painful proptosis are more common often because of thrombosis or bleeding behind. Headache is associated at such time. When there is enlargement or increased blood flow in these varices the pain aggravates as in Stress, migraine.
Particularly in case of primary varices with no obvious cause ( clear CT / MRI ), as in your daughter's case, do not require aggressive treatment. In cases of acute thrombosis or hemorrhage, surgery may be required to remove a hematoma or clotted vessel. Your doctor also weighs risks vs benefits, I believe he feels it is better not to interfere.
If you are too much worried about a catastrophe in the form of severe bleeding and If your daughter is struggling with severe intermittent exophthalmos and cosmetic disfigurement, treatment by electroembolization is a safe and relatively easy procedure, particularly if the orbital varix is consistent with saccular or segmental venous dilatations.
As the varices are hamartomas, they are best left alone than a painful and complication associated surgical repair. The surgical repair is rarely complete and moderately successful as inferred by a large study.
Till then pain can be controlled by methods as described earlier.
Hope it helps.
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