Aneurysm of the Orbital Part of the Ophthalmic Artery.

DuKE-ELDER (1952) stated that orbital aneurysms of the ophthalmic arterywere very rare and that several of the reports lacked anatomical verification. Such cases were described by Guthrie (1823), Carron du Villards (1838), Passavant (1866), Dempsey (1886), Ritter (1887), de Vincentiis (1892), de Schweinitz and Holloway (1908), and Vail and Oliver (1914). Heimburger, Oberhill, McGarry, and Bucy (1949) reviewed the literature as regards intra-orbital aneurysms, and gave a short summary of six cases in which the diagnosis seemed reasonably sound. They reported an aneurysmal dilatation of the lacrimal artery removed by the transcranial route. Without arteriography, it seems unlikely that the diagnosis of orbital aneurysm can be established without operation. Angiograms were taken by Huber (1951) and Kinley and Leighninger (1952). Weakening of the arterial wall may be due to a developmental malformation, trauma, arteriosclerotic degeneration, or a septic embolus usually from bacterial endocarditis. Moore (1925) described a mycotic ophthalmic aneurysm which caused complete rupture of the optic nerve. The ophthalmic artery aneur-ysms described were rarely of the saccular variety, but rather consisted of a dilatation of the artery over a long segment. Pfingst (1936), who concluded that up to that date no case of saccular aneurysm of the ophthalmic artery had been proved, described a unilateral fusiform distension of the ophthalmic artery. Sanford, Craig, and Wagener (1935) reported a bilateral fusiform aneurysm of the ophthalmic artery verified by operation. There is no particular histological feature by which an arterial dilatation of this kind can be distinguished from a fusiform aneurysm. Walsh (1957) summarized the signs of aneurysm of the ophthalmic artery as: proptosis, optic atrophy or papilloedema, field defects, diplopia, and limitation of ocular movements, saying that "it seems unlikely that ocular pulsation is present; certainly in most of the instances pulsation signifies arteriovenous aneurysm". Sverdlick and Veppo (1950) described nonpulsating exophthalmos associated with fusiform dilatation of the