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A 13-day-old baby, born of a full term, uncomplicated, normal vaginal delivery at a primary healthcare centre presented with severe bilateral proptosis. At 12 h postpartum a presumed subconjunctival haemorrhage was seen on the temporal aspect of the right eye following which bilateral, rapid onset, painless proptosis developed.
At presentation in the department of ophthalmology CSMMU Lucknow, the child had bilateral, severe, axial, non-pulsatile, almost symmetrical proptosis, along with forniceal prolapse, conjunctival chemosis and exposure keratopathy. The ocular movements were restricted in all directions in both the eyes. There was no fundal view because of the severe exposure keratopathy (figure 1A). The systemic examination was normal and no evidence of bleeding diathesis or battering was found.
What is the differential diagnosis of severe proptosis in a neonate?
What are the most relevant investigations?
What are the immediate management options?
What are the long term issues in this case?
Answers (For Questions see 793) 1. What is the differential diagnosis of severe proptosis in a neonate?
Bilateral neonatal proptosis is rare. Several causes of proptosis in neonates have been discussed in literature. Orbital cysts are the most common with others being encephalocoele or meningomyelocoele, …
Contributors AK and SM have contributed equally in the conception and design, acquisition and analysis of data; drafting the article or revising it critically for important intellectual content; and final approval of the version to be published.
Competing interests None.
Patient consent Parental consent obtained..
Provenance and peer review Not commissioned; externally peer reviewed.
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