Post-tussive Periorbital Ecchymosis in a Child Without Trauma: A Rare Neuro-Ophthalmic Presentation

Periorbital ecchymosis without preceding trauma is unusual and may be observed after events that increase venous pressure, such as coughing. We report a case of a three-year-old male who developed bilateral periorbital ecchymosis and subconjunctival hemorrhage following a bout of severe coughing. There was no history of trauma, hematologic disorder, or neoplastic process. Ocular motility and fundus findings were normal. Neuroimaging and systemic investigations were unremarkable. Symptoms resolved spontaneously with conservative management. Post-tussive periorbital ecchymosis is a rare but benign clinical entity in the pediatric population. Recognition of this presentation is important to avoid unnecessary investigations and to distinguish it from traumatic or systemic causes of periorbital bruising.