Varix of the vortex ampulla.

In five patients, extreme gaze resulted in the appearance and expansion of a lesion located at the site of a venous vortex ampulla. The dimensions and color of the lesion varied depending upon the direction and duration of gaze. The lesion expanded when the head was positioned below the level of the heart and when a Valsalva maneuver was performed, even when the primary position of gaze was maintained. The lesion rapidly detumesced and disappeared when the head was elevated, digital pressure was exerted on the globe, or gaze was directed elsewhere. Fluorescein angiography confirmed that this tumefaction originated from the venous vortex ampulla. These dynamic features observed ophthalmoscopically and demonstrated by ultrasonography are characteristic of the vortex ampulla varix; the lesion should not be confused with a malignancy.