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First description of a retrobulbar haemorrhage in a paediatric patient
Hirvi Hindocha1, Sarah Edwards2
1Emergency Department, University Hospitals of Leicester NHS Trust, Leicester, UK.
Insights
A rare retrobulbar hematoma in an 8-year-old girl, following orbital fracture surgery, caused vision loss. Prompt lateral canthotomy decompression successfully restored her sight, highlighting the importance of urgent intervention.
Area of Science:
- Ophthalmology
- Pediatric Emergency Medicine
- Trauma Surgery
Background:
- Orbital floor fractures can lead to serious complications.
- Retrobulbar hematomas are rare in pediatric patients, especially after trauma surgery.
- Delayed diagnosis of retrobulbar hematoma can result in permanent vision loss.
Abstract:
An 8-year-old girl presented to the paediatric emergency department 3 days after left orbital exploration for an orbital floor fracture. She had been vomiting for the last 24 hours and her mother's primary reason for presentation was that she was unable to keep down any analgesia . She reported pain in that eye and was unable to see. On examination, the eye was swollen and had yellow discharge. A CT scan was performed to rule out an infective collection and, unexpectedly, showed a retrobulbar haematoma. Ophthalmology was called and she was immediately taken to theatre for a lateral canthotomy for decompression. Fortunately, she regained her vision following this but, had the retrobulbar haematoma not been recognised urgently, she may have lost her vision permanently in that eye. Retrobulbar haematomas are quite rare in children this age and there is very little published literature on this topic.
