Spontaneous Periocular Ecchymosis in Children: Differential Diagnosis and Current Trends in Evaluation and Management

Abstract

While periocular ecchymosis commonly develops following surgery or traumatic injury to the orbit, the spontaneous appearance of periocular ecchymosis in children can indicate the presence of life-threatening conditions including pediatric malignancies (neuroblastoma, rhabdomyosarcoma, leukemia) and hematologic disorders (aplastic anemia, thrombocytopenia). Vascular malformations (capillary hemangioma, lymphangioma, orbital varix), inflammatory conditions (orbital myositis, amyloidosis), pertussis, and Blue rubber bleb nevus syndrome are benign differential considerations with visual complications in certain instances. Since spontaneous periocular ecchymosis (SPE) can be encountered by pediatric subspecialists both within and outside ophthalmology, the authors present a review of the current literature integrating the clinical features, latest diagnostic investigations, and updates in management for the entities that cause spontaneous periocular ecchymosis in children. A comprehensive and current understanding of the differential diagnosis elicited by this unique ocular finding will aid the clinician in managing long-term visual consequences and coordinating with appropriate pediatric subspecialists.

Periorbital Ecchymosis: An Uncommon Complication of Cochlear Implantation

“…Kavoussi et al mentioned the other causes of periocular ecchymosis: the spontaneous appearance of periocular ecchymosis in children can indicate the presence of life-threatening conditions including pediatric malignancies (neuroblastoma, rhabdomyosarcoma, leukemia) and hematologic disorders (aplastic anemia, thrombocytopenia), vascular malformations (capillary hemangioma, lymphangioma, and orbital varix), inflammatory conditions (orbital myositis, amyloidosis), and pertussis [9].…”

“…After the entire required test showed no any surgical contraindication. Patient performed right ear cochlear implantation via facial recess approach [1][2][3][4][5][6][7][8][9][10]. Intraoperative ART and NRT showed values with in normal range C-arm X-ray imaging showed electrode arrays implanted with in cochlea (Figure 2).…”

Flurbiprofene bağlı tek taraflı perioküler kanama: Nadir bir ilaç yan etkisi

“…Perioküler alandaki kanama eğilimi, bu zengin vasküler beslenmeyle ince göz kapağı ve periorbital deri kombinasyonundan kaynaklanır. [1] Flurbiprofen, anti-inflamatuar aktiviteye sahip bir prostaglandin-sentetaz inhibitörüdür. Romatoid artrit ve osteoartrit tedavisinde 1988 yılında Amerika Birleşik Devletleri Gıda ve İlaç Dairesi (ABD FDA) tarafından onaylanmıştır.…”

“…Kanamanın göz çevresinde olması bu bölgenin ince damar yapısıyla ilişkilendirilebilir. [1] Hastadan alınan öyküye göre ilacı akşam saatlerinde almış ve kısa süre sonra uyumuştur. Perioküler kanamanın tek taraflı olması ise hastanın uyurken aldığı, yatış pozisyonundaki basıya bağlı olarak düşünülebilir.…”