BACKGROUND: Intra-orbital hematoma is an eye disease that is
usually attributed to trauma, neoplasm, acute sinusitis or vascular
malformations. However, spontaneous hematoma is a rare
condition and can be an early manifestation of hematological
disorders.
CASE REPORT: This is a case report on a 2-days old male
neonate presented with proptosis of the right eye since the second
day of birth. The pregnancy was term and the delivery was at
health center by spontaneous vaginal delivery in which no
instruments were used. He had no history of trauma and no
bleeding from other sites. On physical examination, he had axial
proptosis of the right eye of 26mm, injected conjunctiva and
corneal ulcer with infiltrates. On complete blood count, white
blood cell was 23.53x103, red blood cells= 3.96x106, platelets =
279x103/μL, hemoglobin = 13.5g/dl, hematocrit = 38.7%.
Coagulation profile test showed; prothrombin time = 5.1 with
reference range of (10- 14 seconds); partial thromboplastin time =
24.9 reference range of (22-27seconds)
and international
normalization ratio = 0.4 with reference range (0.8- 1.1).
Ultrasound showed hematoma collection, and clotted blood was
surgically drained with no other intra-operative finding. After the
surgery, he took systemic and topical antibiotics, and
progressively, the proptosis, conjunctival injection and corneal
ulcer improved.
CONCLUSION: In our case, we were not able to know the exact
cause for the orbital hematoma. Although it is not common, we
have to consider the possibility of spontaneous hematoma as a
cause of sudden proptosis in neonates.
KEY WORDS: Proptosis, orbital hematoma, Hemorrhagic disease
of new born

Published: 2019-05-28