The angular vein forms at the inner corner of the eye where the supratrochlear and supraorbital veins meet. It runs down the side of the nose and becomes the facial vein at about the level of the lower eyelid. It connects with the superior ophthalmic vein, giving a direct route from the face to the cavernous sinus inside the skull.
| Origin | Union of the supratrochlear and supraorbital veins at the medial angle of the eye |
|---|---|
| Course | Runs obliquely down the side of the root of the nose and becomes the facial vein at the lower border of the orbit |
| Branches |
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Because blood can flow from the angular vein back through the ophthalmic veins to the cavernous sinus, infections of the central face (the so-called danger triangle between the nose and the corners of the mouth) can rarely spread inside the skull. Septic cavernous sinus thrombosis presents with fever, swelling around the eye, bulging eye, painful eye movements and cranial nerve palsies. The angular vein also lies near the medial canthal tendon and is met in lacrimal and medial canthal surgery.
Infection of the central face or sinuses spreads via the angular and ophthalmic veins to the cavernous sinus, causing a dangerous illness with eye swelling and cranial nerve palsies that needs urgent antibiotics.
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