Patient 2 was a 31-year-old woman. Her right orbital lymphangioma began growing around menarche, and she underwent multiple excisions over 20 years. Her most recent surgical attempt consisted of 3-wall orbital decompression with bone removal. The lesion continued to grow and at her first visit with us, her VA in the right eye was reduced with a relative afferent pupillary defect. Importantly, the left eye was amblyopic, and she was debilitated from vision loss in her better eye (Figure 2A-C). Her initial best-corrected VAs were 20/100 OU and exophthalmometry revealed 15 to 20 mm of right-sided proptosis. Orbital imaging with magnetic resonance imaging and computed tomography revealed an infiltrating lymphangioma with fibrosis and calcification (Figure 2G-H). Examination revealed right optic disc elevation, retinal striae, and macular folds. Humphrey visual field test results over 3 visits showed an enlarging paracentral scotoma. Because of lesion size, progression of symptoms, and gross deformity, she proceeded with surgical excision with adjunctive sodium morrhuate injection. Preoperative dynamic MRA revealed no communication between the lymphangioma and orbitocranial vasculature (data not shown). She underwent an anterior orbitotomy with excision of the infiltrative lesion (Figure 2I). Adjunctive sodium morrhuate injection was used to reduce the risk of hemorrhage and sclerose elements of the lesion left behind in the deep orbit. Her postoperative course was excellent with improvement of vision and afferent pupillary defect. Because of the absence of a bony orbital floor from prior decompression surgery, she developed globe dystopia (Figure 2D-F), but this was mild and no further intervention was recommended. On her most recent examination at 1 year postsurgery, her VAs were 20/60 OD and 20/100 OS. Exophthalmometry showed 3 mm of right-sided enophthalmos. Her fundus examination revealed mild pigmentary changes but was otherwise unremarkable.