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CASE REPORT
Year : 2022  |  Volume : 2  |  Issue : 4  |  Page : 974-976

Post-traumatic orbital subperiosteal hematoma presenting as proptosis with Curvularia keratitis


Department of Ophthalmology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India

Correspondence Address:
Dr. Saroj Gupta
All India Institute of Medical Sciences, Saket Nagar Bhopal, Madhya Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_773_22

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A 13-year child presented with protrusion of the left eye (LE) with redness, pain, and diminution of vision following blunt head trauma. The best-corrected visual acuity (BCVA) in the LE was hand movement. On examination, LE had abaxial proptosis with lagophthalmos and severe exposure keratopathy. There was a large corneal ulcer with feathery margins and superficial brown pigmentation, confirmed as Curvularia spp. on microbiological assessment. A computed tomography (CT) scan of the orbit and brain demonstrated superior subperiosteal hematoma of the orbit and frontal epidural hematoma. Aspiration of blood from subperiosteal orbital hematoma resulted in an immediate reduction of proptosis. The epidural hematoma resolved spontaneously. Treatment with topical and systemic antifungal agents resulted in complete healing of the keratitis with a residual leucomatous corneal opacity. Emergency treatment of subperiosteal orbital hematoma through needle aspiration helps in the early resolution of proptosis, exposure keratopathy, and visual loss.


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