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Intraorbital Haematoma During a Commercial Flight: A Case Report

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Case Reports

Intraorbital Haematoma During a Commercial Flight: A Case Report

Alper Mete et al. BMC Ophthalmol.

Abstract

Background: Intraorbital haematoma is a rare clinical entity which can be caused by orbital traumas, neoplasms, surgeries nearby sinuses and orbit, vascular malformations, acute sinusitis, systemic abnormalities, barotrauma and valsalva maneuver.

Case presentation: A 74-year-old male presented with sudden onset of ocular pain, upper eye lid swelling, proptosis and diplopia after a commercial flight. After complete ophthalmic ocular examination including pupillary light reflexes and laboratory examinations; computed tomography and magnetic resonance imaging of orbit revealed a subperiostal mass-like lesion in the right retrobulbar-extraconal region which was compatible with intraorbital haematoma. Visual acuity was not compromised so we planned a conservative approach with close observation. We administered systemic corticosteroid and topical dorzolamide/timolol combination therapy. At the first month follow-up, intraorbital haematoma resolved without significant sequelae.

Conclusion: Intraorbital haematoma can be managed by conservative approach without any intervention if it does not threat visual acuity or optic nerve. We experienced a case of intraorbital haematoma during a commercial flight. We discussed the rarity of this condition and its management.

Figures

Figure 1
Figure 1
Patient had subconjunctival haemorrhage, proptosis and lateral gaze restriction in the right eye at presentation.
Figure 2
Figure 2
Axial (A) and Coronal (B) CT images of orbit revealed high density mass-like lesion in retrobulbar-extraconal part of right orbit consistent with subperiostal haematoma which displaces bulbus oculi, lateral rectus muscle and optic nerve.
Figure 3
Figure 3
Axial fat sat T1-weighted MRI which showed ovoid shaped hyperintensity at right retrobulbar-extraconal region consistent with subperiostal haematoma.
Figure 4
Figure 4
Proptosis and lateral gaze restriction recovered at the first month follow-up. Ocular movements were normal in all directions.

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