CASE REPORT article
Front. Surg.
Sec. Pediatric Surgery
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1594871
This article is part of the Research TopicAdvances and Challenges in Neonatal Surgery: Congenital and Acquired ConditionsView all 24 articles
A Case of Traumatic Subgaleal Hematoma with Delayed Massive Exophthalmos
Provisionally accepted
- 1Seoul Ire Eyeclinic, Kyung Hee University School of Medicine, Seoul, Republic of Korea
- 2Department of Ophthalmology, Kyung Hee University Hopsital at Gangdong, Kyung Hee University School of Medicine, Seoul, Republic of Korea
- 3Department of Ophthalmology, Kyung Hee University Medical Center, Kyung Hee University School of Medicine, Seoul, Republic of Korea
- 4Department of Neurosurgery, Kyung Hee University Hopsital at Gangdong, Kyung Hee University School of Medicine, Seoul, Republic of Korea
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Progressive exophthalmos occurring after minor trauma is very rare, it is important to consider subgaleal hematoma in the differential diagnosis. If diagnosis is delayed, permanent vision loss may occur due to optic nerve damage or corneal damage due to pressure, so performing decompression surgery at an appropriate time is effective in preventing blindness. A 16-year-old male patient with Lennox-Gastaut syndrome and developmental disability was admitted to the hospital 2 weeks after a head injury due to increased swelling and ecchymosis of left eyelid and suspicion of compressive optic neuropathy of the left eye due to massive exophthalmos. Visual acuity measurement was not possible due to the patient's condition., and the intraocular pressure in the left eye was 20 mmHg. The pupil size in both eyes was the same, and there was a pupil reflex in the left eye, and there were no abnormal findings in the blood coagulation test. Computed tomography (CT) showed a subperiosteal hematoma in the left orbit and left eye severe proptosis and deviation. To control intraocular pressure and relieve exposure keratopathy, the orbital hematoma was removed through a sub-brow incision, and a lateral canthotomy was performed, and a drain was installed to drain blood accumulated in the orbit under general anesthesia. Orbital CT taken for follow-up observation showed that the hematoma had decreased compared to the day of visit. Regarding the subgaleal hematoma, hematoma was aspirated three times at the neurosurgery department. After surgery, ointments for exposure keratopathy. During follow-up, corneal transparency was maintained and visual acuity was confirmed to be intact by VEP (Visual Evoked Potential).
Keywords: Compressive optic neuropathy, Exposure keratopathy, Orbital subperiosteal hematoma, subgaleal hematoma, Surgical drainage
Received: 17 Mar 2025; Accepted: 08 Aug 2025.
Copyright: © 2025 Lee, Jung, Joo, Park, Koh, Kang and SHIN. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: JAE-Ho SHIN, Department of Ophthalmology, Kyung Hee University Hopsital at Gangdong, Kyung Hee University School of Medicine, Seoul, Republic of Korea
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