Subperiosteal orbital hemorrhage as initial manifestation of Christmas disease (factor IX deficiency)

Medhat F. Guirgis, William A. Segal, Gregg T. Lueder

Research output: Contribution to journalArticlepeer-review

34 Scopus citations


PURPOSE: To report a case of subperiosteal orbital and subgaleal hemorrhage with optic nerve compromise in a patient with a factor IX deficiency. DESIGN: Interventional case report. METHODS: A 5-year-old male presented 10 days after mild trauma with progressive left-sided scalp swelling, proptosis, and visual loss. RESULTS: The patient had marked proptosis of the left eye, 20/200 visual acuity, and an afferent pupillary defect. Magnetic resonance imaging demonstrated a large subgaleal and left subperiosteal orbital hematoma. Quantitative assays of coagulation proteins identified a factor IX deficiency (Christmas disease). CONCLUSION: Delayed-onset subgaleal and subperiosteal orbital hematoma can rarely be an initial manifestation of Christmas disease.

Original languageEnglish
Pages (from-to)584-585
Number of pages2
JournalAmerican journal of ophthalmology
Issue number4
StatePublished - 2002


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