Recurrent vitreous haemorrhage and epidural haematoma in a child with hypofibrinogenaemia

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Ahmad M Mansour1, Mahmoud O Jaroudi

  • 1Department of Ophthalmology, American University of Beirut, Beirut, Lebanon. ammansourmd@gmail.com

BMJ Case Reports
|July 11, 2012
PubMed

Insights

Hypofibrinogenaemia, a rare bleeding disorder, can cause severe ocular hemorrhage and vision loss in infants. Early diagnosis is crucial for managing this condition and preventing irreversible eye damage.

Area of Science:

  • Ophthalmology
  • Hematology
  • Pediatrics

Background:

  • Ocular hemorrhage in infants can stem from various causes, including trauma and genetic disorders.
  • Prompt diagnosis and management are critical for preserving vision.

Observation:

  • A 14-month-old infant presented with unilateral red eye, hyphema, vitreous hemorrhage, and lens subluxation.
  • Imaging revealed an epidural hematoma; however, signs of shaken baby syndrome were absent.
  • The infant exhibited very low fibrinogen levels, with a family history of hypofibrinogenaemia.

Findings:

  • The infant was diagnosed with hypofibrinogenaemia, a genetic disorder characterized by low fibrinogen levels.
  • Despite surgical intervention for recurrent vitreous hemorrhage, the infant experienced phthisis and vision loss.
  • Hypofibrinogenaemia was identified as the underlying cause of the severe ocular complications.

Implications:

  • Hypofibrinogenaemia should be considered in the differential diagnosis of pediatric ocular hemorrhage and vision loss.
  • This case highlights the importance of family history and hematological evaluation in unexplained ocular conditions.
  • Timely identification and management of hypofibrinogenaemia can potentially alter the prognosis of ocular complications.

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