A 10-year-old child presented at a large teaching hospital with the sudden onset of painful proptosis of her left eye that started several days previously. The parents gave a history of several episodes of less extreme protrusion of the globe that had occurred several times over the past 2 years but had always resolved spontaneously without any medical treatment. Examination found 7 mm of proptosis of that eye with moderate subconjunctival hemorrhage and several hemorrhagic cysts under her upper eyelid. There was firm resistance to retropulsion of the globe. The vision was normal as was the intraocular pressure. The fundus examination was unremarkable. Extraocular movements were full.
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