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Proptosis after hair pulling

Chee-Chew Yip1, Timothy J McCulley, Robert C Kersten

  • 1Cincinnati Eye Institute and The University of Cincinnati College of Medicine, Department of Ophthalmology, Cincinnati, Ohio, U.S.A.

Ophthalmic Plastic and Reconstructive Surgery
|March 20, 2003
PubMed

Insights

Hair pulling can cause a subgaleal bleed, leading to a subperiosteal orbital hematoma and proptosis. Prompt surgical evacuation is crucial for favorable outcomes in vision-threatening cases.

Area of Science:

  • Ophthalmology
  • Pediatric Medicine
  • Trauma Surgery

Background:

  • Subperiosteal orbital hematomas are rare but serious conditions.
  • Subgaleal hematomas can result from minor head trauma, including hair pulling.

Observation:

  • A 13-year-old boy presented with progressive proptosis after hair pulling.
  • Imaging revealed a subgaleal hematoma and a superior subperiosteal orbital hematoma.

Findings:

  • The subgaleal bleed extended into the orbital subperiosteal space.
  • The patient developed compressive optic neuropathy due to the orbital hematoma.

Implications:

  • Hair pulling is a potential cause of subperiosteal orbital hematomas.
  • Early recognition and surgical intervention are vital to prevent vision loss.
  • Clinicians managing subgaleal hematomas should consider this potential ophthalmic complication.

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