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Electroretinogram Recording for Infants and Children under Anesthesia to Achieve Optimal Dark Adaptation and International Standards
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Electroretinogram Recording for Infants and Children under Anesthesia to Achieve Optimal Dark Adaptation and International Standards

Published on: September 3, 2020

[Vitamin K antagonist overdose induced blindness in an infant: an argument for a therapeutic educational program]

E Bui Quoc1, D Bonnet, F Bajolle

  • 1Service d'ophtalmologie, hôpital Robert-Debré, 48, boulevard Sérurier, 75019 Paris, France. emmanuel.bui-quoc@rdb.aphp.fr

Archives De Pediatrie : Organe Officiel De La Societe Francaise De Pediatrie
|December 16, 2011
PubMed

Insights

A child on warfarin (a vitamin K antagonist) experienced blindness after a head injury due to unmonitored overdose. This highlights the critical need for patient education and close supervision during VKA therapy.

Area of Science:

  • Pediatric Cardiology
  • Hematology
  • Ophthalmology

Background:

  • Vitamin K antagonist (VKA) therapy necessitates rigorous International Normalized Ratio (INR) monitoring.
  • Pediatric patients on VKA treatment require specialized supervision and education.
  • Head injuries pose significant risks for patients undergoing VKA therapy.

Observation:

  • A 7-year-old child with a single ventricle, post-total cavopulmonary shunt, was on VKA therapy.
  • Following a moderate head trauma, the child developed a frontal hematoma, with parents not monitoring INR.
  • Delayed medical attention revealed elevated INR (5.6) and bilateral orbital hematomas, leading to surgical evacuation and unilateral blindness.

Findings:

  • Suboptimal INR monitoring post-head trauma in a pediatric VKA patient.
  • Severe intracranial hemorrhage complicated by VKA overdose.
  • Permanent unilateral blindness as a sequela of the intracranial hemorrhage and VKA overdose.

Implications:

  • VKA overdose can lead to devastating complications, including permanent vision loss.
  • Emphasizes the critical importance of comprehensive VKA therapeutic education for pediatric patients and their caregivers.
  • Highlights the need for vigilant INR monitoring, especially after trauma, in children on VKA therapy.
Abstract

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