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Bilateral orbital hemorrhage in a newborn
E M Ezzadin1, D Liu, W Al-Rashed
1Oculoplastic and Orbit Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia. kkeshres@prime.net.sa
Insights
Severe bilateral proptosis in a newborn, caused by spontaneous orbital hemorrhage, resolved with conservative management. Magnetic resonance imaging (MRI) aided diagnosis, showing complete recovery without complications.
Area of Science:
- Ophthalmology
- Neonatology
- Pediatric Radiology
Background:
- Orbital hemorrhage is a rare cause of proptosis in newborns.
- Differential diagnosis and management are crucial for favorable outcomes.
Observation:
- A 13-day-old male infant presented with severe bilateral proptosis since birth.
- Clinical examinations and advanced imaging (CT, MRI) were utilized for monitoring.
- Magnetic resonance imaging revealed bilateral subperiosteal orbital hemorrhage.
Findings:
- Conservative management with antibiotic ointment and patching led to decreased proptosis.
- Complete recovery was achieved within 14 days.
- No late complications were observed at 1-year follow-up.
Implications:
- Spontaneous orbital hemorrhage, though uncommon, should be considered in neonates with proptosis.
- MRI is valuable for diagnosing subperiosteal orbital hemorrhage.
- Conservative management is recommended for this condition in newborns.
Purpose:
To report a case of severe bilateral proptosis resulting from orbital hemorrhage in a newborn and to discuss the differential diagnoses and management.
Method:
Case report of a 13-day-old male infant with bilateral proptosis since birth. The proptosis was monitored with clinical examinations and computed tomography as well as magnetic resonance imaging (MRI) scans, and it was managed with antibiotic ointment and patching. The MRI scans demonstrated bilateral subperiosteal orbital hemorrhage.
Results:
Proptosis decreased, and there was successful, complete recovery without untoward sequelae in 14 days; follow-up indicated no late complications at age 1 year.
Conclusion:
Spontaneous orbital hemorrhage, unilateral or bilateral, is uncommon in an otherwise healthy newborn without apparent history of birth trauma. Magnetic resonance imaging scans are helpful in making the diagnosis of subperiosteal hemorrhage, and conservative management is advised.
