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Distended vessels near the inner canthus of the eye and in the supraorbital region

A young ship carpenter, a patient of neurosurgeon Harvey Cushing (1869-1939), with pulsating exophthalmos from a traumatic carotid-cavernous fistula (what Cushing labeled an "arteriovenous aneurysm"), a complication of basal skull fracture, showing distended (and pulsating) vessels near the inner canthus of the eye and in the supraorbital region. In addition, the patient is attempting to look to his right, demonstrating an incomitant esodeviation in the abducting right eye. (From: Cushing 1907. Public domain.)