Spontaneous Retrobulbar Hemorrhage in a Previously Healthy Infant

Abstract

Spontaneous retrobulbar hemorrhage is a rare yet vision-threatening condition. We reported a 5-month-old male infant with sudden onset of left eye proptosis with no prior history of getting vitamin K injection after birth. Head computed tomography scan revealed retrobulbar and intracranial hemorrhages. Laboratory results showed anemia, prolonged prothrombin and activated partial thromboplastin time, supporting the diagnosis of vitamin K deficiency bleeding. After the bleeding and clotting profile were stabilized, lateral canthotomy and cantholysis; and drainage following orbital decompression were successfully performed, yielded in a completely resolved proptosis. The right timing for surgery with the goal of releasing intraorbital pressure represent the merit of this paper. Our case also led to a crucial emphasis on vitamin K prophylaxis at birth.

Tendon-Sparing Extraocular Muscle Enlargement Associated With Chronic Inflammatory Demyelinating Polyradiculoneuropathy

“…1 In a large retrospective study of 132 patients with CIDP, the most commonly involved cranial nerves were as follows: facial and glossopharyngeal at 9%, oculomotor and abducens at 5%, trigeminal at 3%, vestibulocochlear at 2%, and optic nerve at 1%. 4 In our case, the following nerves were involved: right oculomotor, bilateral trigeminal, left abducens, bilateral facial, and bilateral vestibulocochlear. Clinically, the left abduction limitation in our patient likely reflected both abducens nerve involvement and EOM enlargement.…”

“…3 Cases of spontaneous retrobulbar hemorrhage due to underlying coagulopathy have been reported in patients with Vitamin K deficiency, dabigatran use, idiopathic thrombocytopenic purpura, hemophilia A, scurvy, and warfarin use. [4][5][6][7] The majority of reported cases are unilateral. This is, to our knowledge, the first reported case of spontaneous bilateral retrobulbar hemorrhage due to warfarin misuse.…”

Retrobulbar hemorrhage during strabismus surgery

“…It must be emphasized, that all the abovementioned episodes were noted in patients without any hematological disorders, which could explain the occurrence of RH. 6 , 7 Coagulation deficiencies are well-recognized risk factors for intraorbital hemorrhage 8 , 9 , 10 ; however, there are cases of RH that are hard to explain, or at least astonishing. A serious event of bilateral retrobulbar bleeding was reported in the course of strabismus surgery and was believed to be associated with concentrated garlic intake in the form of a tablet.…”

Bilateral Spontaneous Retrobulbar Hemorrhage due to Warfarin Misuse After Sinus Lavage

“…3 Cases of spontaneous retrobulbar hemorrhage due to underlying coagulopathy have been reported in patients with Vitamin K deficiency, dabigatran use, idiopathic thrombocytopenic purpura, hemophilia A, scurvy, and warfarin use. 4–7 The majority of reported cases are unilateral. This is, to our knowledge, the first reported case of spontaneous bilateral retrobulbar hemorrhage due to warfarin misuse.…”