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Photo Essay | June 1999

Scurvy Causing Bilateral Orbital Hemorrhage

Brian Sloan, MB, BCh, MHB, FRACO; Dwight R. Kulwin, MD; Robert C. Kersten, MD

Arch Ophthalmol. 1999;117(6):842-843. doi:10.1001/archopht.117.6.842.

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A 13-YEAR-OLD white girl had an 18-hour history of spontaneous right proptosis (Figure 1) and significant periorbital and retrobulbar discomfort. This had developed while she was resting quietly. She had not recently taken aspirin, nonsteroidal anti-inflammatory drugs, or anticoagulants.

Figure 1.

Appearance of patient at time of presentation with right-sided proptosis. The superior sulcus was expanded and tense to palpation.

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Figure 1.

Appearance of patient at time of presentation with right-sided proptosis. The superior sulcus was expanded and tense to palpation.

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Figure 2.

Swollen, bleeding gums present at initial evaluation.

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Figure 3.

Coronal computed tomographic scan revealed bilateral superior subperiosteal orbital hematomas.

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Appearance of patient 10 days after starting oral ascorbic acid therapy. The proptosis has resolved, though mild subconjunctival hemorrhages are still present.

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Figure 5.

Bleeding and swollen gums improved after a few days of oral ascorbic acid treatment.

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Sloan B, Kulwin DR, Kersten RC. Scurvy Causing Bilateral Orbital Hemorrhage. Arch Ophthalmol. 1999;117(6):842-843. doi:10.1001/archopht.117.6.842.

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