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Figure 1

Figure 2

Photos courtesy of: Prof. Dinesh Selva, Adelaide, Australia
Used with permission. Not to be reproduced.

A 36-year-old man presented with a history, since childhood, of deep pain around his right eye, with intermittent forward protrusion, which worsened on coughing or straining (Figure 1). Visual acuity was 6/6 bilaterally and extraocular movements were full. Examination showed 1.5 mm enophthalmos in the right eye and normal anterior and posterior segment in both eyes. Computed tomography scans showed an irregular mass behind the globe, as shown in Figure 2.

1.	What is the clinical diagnosis?
	a. lymphangioma b. hemangioma c. orbital varices d. lymphoma
2.	Which test would be supportive in your diagnosis?
	a. Hertel's exophthalmometry b. Valsalva's maneuver c. computed tomography d. all of the above
3.	The management would be:
	a. observation b. debulking c. excision biopsy d. intervention radiology

For answers to the above, click here on or after April 28, 2009.