Sudden Painful Proptosis following Orbital Evisceration: Early Implant Hemorrhage in the Anophthalmic Socket.

Purpose: To report a case of early orbital hemorrhage following four-petal evisceration and highlighting the clinical presentation, diagnostic process, and surgical management.

Methods: A 49-year-old male patient, with a history of chronic renal insufficiency on renal replacement therapy and anticoagulation treatment, presented with sudden painful proptosis 1 week after four-petal evisceration. Orbital magnetic resonance imaging revealed a hyperintense area suggestive of hemorrhage around the implant. Initial management involved intravenous steroid therapy to alleviate symptoms.

Results: Despite the administration of steroids, the patient's proptosis and associated symptoms persisted. This led to the decision to perform surgical intervention. The surgical procedure encompassed the removal of the silicone implant, evacuation of the hemorrhage, and subsequently reinsertion of the same implant. Postoperatively, the patient's symptoms improved significantly.

Conclusions: To our knowledge, this report represents the first case of early orbital hemorrhage developed following four-petal evisceration. This case underscores the potential for the development of early orbital hemorrhage following four-petal evisceration. Prompt recognition and appropriate surgical intervention are crucial for the management of the hemorrhage and preserving orbital function.