Orbital Varix in a Patient with Acute Hypercapnic Respiratory Failure

Orbital varix is an uncommon vascular malformation of the orbit which usually presents as a unilateral, intermittent, painless prop­tosis of the eye elicited during certain maneuvers like straining. We present a patient with chronic obstructive pulmonary disease complaining about painless proptosis in his right eye which occurred during acute hypercapnic respiratory failure. Right severe hypercapnia with a partial arter­ial carbon dioxide pressure (PaCO2) of 73 mm Hg and severe hypoxaemia with a partial arterial oxygen pressure (PaO2) of 40.3 kPa. The other laboratory findings were nor­mal except a hematocrit of 57%. Orbital magnetic reso­nance imaging (MRI) showed an