Ruiz-Arranz Celia, Mencía-Gutiérrez Enrique, Bengoa-González Álvaro, Pérez-Trigo Silvia, Gutiérrez-Díaz Esperanza
Ophthalmology, 12 de Octubre Hospital, Complutense University, Madrid, ESP.
Cureus. 2020 Oct 31;12(10):e11273. doi: 10.7759/cureus.11273.
A non-traumatic or spontaneous orbital hemorrhage (NTOH) is usually caused by the presence of an orbital mass, an inflammation, an infection, a bleeding disorder or those called idiopathic. This entity usually affects elderly adults and some risk factors can be identified. The NTOH normally acts like a benign and self-limited process, but attending to its anatomical pattern, may need specific management. A 64-year-old male referred to us with sudden binocular double vision, without loss of visual acuity (VA) or pain immediately after fitting the FFP2/NK95 facial mask for air protection during the pandemic COVID-19. He presented sudden orbital-subconjunctival-eyelid cutaneous hemorrhage-hematoma with conjunctival protrusion from the palpebral fissure without proptosis. There was also limitation in adduction and a cutaneous hematoma in the inner third of the lower eyelid. After 48 hours, the diplopia had resolved and ocular motility was completely re-established with persistence of a massive hyposphagma. No radiological image test was performed due to the COVID-19 epidemiological situation, as the patient was in good systemic situation and it was not a vital emergency. The evolution was favorable with conservative treatment, cold application, and moisturizing eye drops. After 10 days, the bruising was almost completely gone. During the ongoing novel coronavirus disease (COVID-19) pandemic caused by the novel enveloped RNA virus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), face mask use has drastically increased among the healthcare professionals and the general population. The importance of this case lies in the new adverse effects caused by the misuse of mandatory face masks in the general population.
非创伤性或自发性眼眶出血（NTOH）通常由眼眶肿物、炎症、感染、出血性疾病或特发性因素引起。该病症通常影响老年人，且可识别出一些危险因素。NTOH通常表现为良性自限性过程，但根据其解剖模式，可能需要特殊处理。一名64岁男性在新冠疫情期间佩戴FFP2/NK95口罩进行空气防护后，立即出现双眼突发复视，无视力（VA）丧失或疼痛。他出现了眼眶-结膜下-眼睑皮肤突发出血-血肿，结膜从睑裂突出但无眼球突出。内收也有受限，下眼睑内三分之一处有皮肤血肿。48小时后，复视消失，眼球运动完全恢复，但仍有大量球结膜下出血。由于新冠疫情形势，未进行影像学检查，因为患者全身状况良好，并非紧急重症情况。经保守治疗、冷敷和使用保湿眼药水后病情好转。10天后，瘀伤几乎完全消失。在由名为严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的新型包膜RNA病毒引起的新型冠状病毒病（COVID-19）大流行期间，医护人员和普通人群中口罩的使用大幅增加。该病例的重要性在于普通人群中不当使用强制性口罩所导致的新的不良反应。
