Cirrhosis-related coagulopathy resulting in disseminated intravascular coagulation and spontaneous orbital hemorrhages.
A 33-year-old patient presented to our Emergency Department (ED) with left-sided eyelid ecchymoses and edema. A CT scan of the orbits demonstrated a left retrobulbar hemorrhage, prompting an ophthalmology consultation. Upon examination, the patient reported worsening eye pain and decreasing vision in the left eye. Despite aggressive management with superior and inferior lateral canthotomy/cantholysis with placement of an orbital drain, visual loss occurred, and the patient ultimately expired from her systemic condition. Coagulopathy from liver disease resulting in systemic hemorrhage is commonly seen. Orbital hemorrhage in this setting requires emergent diagnosis and management to prevent irreversible compressive optic neuropathy.
Jules Stein Eye Institute/UCLA , Los Angeles, CA , USA , and.
Julia
J
Nemiroff
Samuel
S
Baharestani
Viral V
VV
Juthani
Kathryn S
KS
Klein
Chris
C
Zoumalan
D000328:Adult; D001766:Blindness / Q000209:etiology; D004211:Disseminated Intravascular Coagulation / Q000175:diagnosis / Q000209:etiology*; D004438:Ecchymosis / Q000209:etiology; D004487:Edema / Q000209:etiology; D005141:Eyelid Diseases / Q000209:etiology; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D019315:Retrobulbar Hemorrhage / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D014792:Visual Acuity
Cirrhosis; retrobulbar hemorrhage; spontaneous orbital hemorrhage