Orbital hematoma due to vitamin K deficiency in an infant

Area of Science:

• Ophthalmology
• Pediatrics
• Hematology

Background:

• Vitamin K deficiency bleeding (VKDB) typically presents in early infancy.
• Late-onset VKDB is uncommon but can manifest with severe complications.

Observation:

• A 3-month-old boy presented with acute orbital compartment syndrome and severe proptosis.
• Massive hemorrhage in the right orbit was identified as the cause.
• Coagulation profile revealed significant abnormalities consistent with vitamin K deficiency.

Findings:

• Intravenous vitamin K administration corrected the abnormal coagulation profile.
• Surgical drainage of the orbital hematoma was necessary due to the compartment syndrome.
• The patient developed a corneal opacity post-operatively.

Implications:

• This case highlights the potential for late-onset vitamin K deficiency bleeding presenting with ophthalmic emergencies.
• Early recognition and management of VKDB are crucial to prevent severe outcomes.
• Ophthalmic complications, such as corneal opacity, can occur even after successful treatment of the bleeding.