Orbital lymphangioma or lymphatic malformation is congenital or acquired for example can be due to previous trauma, radiation, or surgery and it usually occurs in early childhood and rarely occurs in adulthood.

The usual presentation of orbital lymphangioma is sudden unilateral painful proptosis due to an episode of acute hemorrhage within the mass.

The lymphangioma has minimal internal blood flow and has no obvious vascular connection and usually presents as a multiloculated cystic mass lesion.

The imaging modality of choice for primary evaluation of proptosis is non-contrast orbital MDCT but for further characterization and the relation of the mass to the optic nerve and pretreatment mapping, MRI of the orbit with and without gadolinium is mandatory.

Orbital lymphangioma can encase the optic nerve sheath complex and lead to compressive optic neuropathy.

The main treatment of orbital lymphangioma is complete surgical resection of the mass but sclerotherapy, sildenafil, or sirolimus therapy can also be considered based on the severity of the patient's visual impairment and proptosis.