Ocular Manifestations Of Hemorrhagic Syndrome Of The Newborn

Babies have very small vitamin K reserves at birth. They are at risk of continuous bleeding if they do not have enough vitamin K to generate hemostasis. Internal or external hemorrhages can occur, including in the brain, at any time up to 6 months of age. Our aim is to remind you of the importance of taking vitamin K in newborns, and the clinical variability of the manifestations of not taking vitamin K. We report the case of a newborn at 10 days of age who had presented with exophthalmos since birth, and whose reason for consultation was a retro-orbital hematoma. The child was initially referred to the emergency department for exophthalmos since birth with no other associated signs. On examination, an axillary exophthalmos was found on the right side, painful on pressing, causing crying, irreducible with impossible spontaneous palpebral closure and local subconjunctival haemorrhage in the contralateral eye. Cerebral and orbital MRI revealed a right retroorbital formation, suggesting a subacute hematoma responsible for grade 3 exophthalmos with two small cerebellar hematomas. A complete haemostasis work-up was carried out, including coagulation factor assay, which was unremarkable. The child was admitted to the pediatric ophthalmology ward after neurosurgical and hematological advice, and received vit K at a dose of 2 mg/kg/week for 3 weeks with local care.