Non-traumatic extraocular muscle haemorrhage associated with anticoagulation use

BMJ Case Rep. 2023 Mar 6;16(3):e253860. doi: 10.1136/bcr-2022-253860.

Abstract

We present a case of a unilateral extraocular muscle haematoma in an adult female patient who was compliant with life-long oral anticoagulation for recurrent deep vein thrombosis. The patient presented with symptoms of sudden-onset left-sided headache radiating to the temporal region, which started 2 days prior. No obvious triggering factors were identified. Cranial and ocular examinations were within normal limits. Imaging revealed a haemorrhage related to the lateral rectus muscle of the left eye. Conservative management was employed with abstinence from anticoagulation for 2 weeks and a weaning regime of oral steroids. Under the clinical review of ophthalmology and interval radiological monitoring, symptoms were reduced with reduction of haemorrhage size. Anticoagulation was reinstated after 2 weeks. To our knowledge, this is the first case of a non-traumatic extraocular muscle haematoma to be reported in a patient on anticoagulation.

Keywords: Haematology (drugs and medicines); Musculoskeletal and joint disorders; Ophthalmology; Radiology; Unwanted effects / adverse reactions.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anticoagulants / adverse effects
  • Conservative Treatment*
  • Eye
  • Female
  • Hematoma / chemically induced
  • Hematoma / diagnostic imaging
  • Humans
  • Oculomotor Muscles* / diagnostic imaging

Substances

  • Anticoagulants