Spontaneous Periocular Ecchymosis in Children: Differential Diagnosis and Current Trends in Evaluation and Management
|Shaheen C Kavoussi1*, Carlos A Pasco2, Katrina A Mears3, Flora Levin1 and J. Javier Servat1|
|1Department of Ophthalmology and Visual Science, Yale University School of Medicine, 40 Temple Street, New Haven CT, 06510, USA|
|2Department of Ophthalmology, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, QLD, 4102, Australia|
|3Department of Ophthalmology and Visual Sciences, University of Iowa College of Medicine, 200 Hawkins drive, Iowa City, Iowa, 52242, USA|
|Corresponding Author :||Shaheen C. Kavoussi, M.D.
Department of Ophthalmology and Visual Science
Yale University School of Medicine
40 Temple St., New Haven, CT 06510, USA
E-mail: [email protected]
|Received April 29, 2014; Accepted June 11, 2014; Published June 18, 2014|
|Citation: Kavoussi SC, Pasco CA, Mears KA, Levin F, Servat JJ (2014) Spontaneous Periocular Ecchymosis in Children: Differential Diagnosis and Current Trends in Evaluation and Management. J Clin Exp Ophthalmol 5:343. doi: 10.4172/2155-9570.1000343|
|Copyright: © 2014 Kavoussi SC, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
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While periocular ecchymosis commonly develops following surgery or traumatic injury to the orbit, the spontaneous appearance of periocular ecchymosis in children can indicate the presence of life-threatening conditions including pediatric malignancies (neuroblastoma, rhabdomyosarcoma, leukemia) and hematologic disorders (aplastic anemia, thrombocytopenia). Vascular malformations (capillary hemangioma, lymphangioma, orbital varix), inflammatory conditions (orbital myositis, amyloidosis), pertussis, and Blue rubber bleb nevus syndrome are benign differential considerations with visual complications in certain instances. Since spontaneous periocular ecchymosis (SPE) can be encountered by pediatric subspecialists both within and outside ophthalmology, the authors present a review of the current literature integrating the clinical features, latest diagnostic investigations, and updates in management for the entities that cause spontaneous periocular ecchymosis in children. A comprehensive and current understanding of the differential diagnosis elicited by this unique ocular finding will aid the clinician in managing long-term visual consequences and coordinating with appropriate pediatric subspecialists.