Indian Journal of Medical Research

CLINICAL IMAGE
Year
: 2020  |  Volume : 152  |  Issue : 7  |  Page : 170--171

Bane of consanguinity - Vision-threatening orbital sub-periosteal haematoma in hypofibrinogenaemia


GP Thanuja, Devappa Namrata 
 Department of Ophthalmology, Ramaiah Medical College Hospital, Bengaluru 560 054, Karnataka, India

Correspondence Address:
G P Thanuja
Department of Ophthalmology, Ramaiah Medical College Hospital, Bengaluru 560 054, Karnataka
India




How to cite this article:
Thanuja G P, Namrata D. Bane of consanguinity - Vision-threatening orbital sub-periosteal haematoma in hypofibrinogenaemia.Indian J Med Res 2020;152:170-171


How to cite this URL:
Thanuja G P, Namrata D. Bane of consanguinity - Vision-threatening orbital sub-periosteal haematoma in hypofibrinogenaemia. Indian J Med Res [serial online] 2020 [cited 2021 Sep 23 ];152:170-171
Available from: https://www.ijmr.org.in/text.asp?2020/152/7/170/316802


Full Text

A nine yr old male child†, born of second-degree consanguineous marriage, was diagnosed with congenital hypofibrinogenaemia seven years back. He presented with progressive right eye proptosis with exposure keratopathy following trivial trauma to the forehead in September 2018, at the department of Ophthalmology, Ramaiah Medical College & Hospital, Bengaluru, India. Computed tomography of the brain showed hyperacute subgaleal and right orbital subperiosteal haematoma of about 35 × 29 × 17 mm in size. Blood parameters revealed fibrinogen levels <10 mg/dl, prothrombin time >120 sec, activated partial thromboplastin time >120 sec and thrombin time >120 sec. Cryoprecipitate infusion was given to stabilize blood parameters. When fibrinogen levels were >200 mg/dl, wide bore needle aspiration of subperiosteal haematoma (Video) and lateral tarsorraphy was done to reduce proptosis and protect cornea. The patient improved with vision of 6/12 after one month.{Figure 1}

Orbital subperiosteal haematoma is a rare presentation following trivial trauma and is usually self-limiting and rarely requires intervention. In bleeding diathesis, orbital subperiosteal haematoma if not aggressively managed may lead to visual loss.

Acknowledgment: Authors acknowledge Dr Somshekhar, department of Peadiatrics, and Dr P. Rashmi, Hemato-Oncologist for participating in patient management.

Conflicts of Interest: None.