2011: The patient had an eye injury, causing right-sided exophthalmos and eyelid swelling. CT scan at the local hospital indicated right orbital tumor, suggestive of hemangioma.
3/15/2011: Under general anesthesia, the patient underwent resection of the right orbital tumor at General Hospital of Armed Police Forces. Postoperative pathology study indicated vascular tumor. Postoperative recovery was good. The eyeball grossly returned to normal position.
8/2011: The patient suddenly presented with exophthalmos which gradually disappeared more than 2 months later.
In late 2011, the patient presented with right-sided exophthalmos again which gradually disappeared spontaneously.
11/2012: The patient presented with right-sided exophthalmos again which worsened gradually and there was no sign of improvement.
3/21/2013: Under general anesthesia, the patient underwent right orbital hematoma resection via combined medial and lateral orbitotomy + embolization for vascular malformation + decompression of orbital medial wall, with uneventful process. On the same day, the patient suddenly presented with exophthalmos and increased orbital pressure, suggestive of postoperative acute intra-orbital hemorrhage which was not improved by conservative treatment.
3/28/2013: Under general anesthesia, the patient underwent stitches removal of right ocular skin incision + palpebral fissure suture removal + puncture and drainage of right orbit, with uneventful process. After that, the exophthalmos was improved and the orbital pressure decreased markedly. For exophthalmos, increased orbital pressure, intra-orbital hemorrhage and blood oozing, the patient was given hemostasis therapy, detumescence and other supportive treatments. The condition was grossly stable. Since the malformed vessel had abundant blood supply and close connection with optic nerve, a second surgery would have high risk. Therefore, to protect the vision and ocular function, she only received close follow-up and no surgical treatment was performed.