Vitrectomy for dense vitreous hemorrhage in infancy.

PURPOSE: To report clinical data, including etiology and visual outcome, in newborns requiring vitrectomy for dense vitreous hemorrhage. METHODS: In this retrospective case series, we surveyed subscribers to the American Association for Pediatric Ophthalmology and Strabismus ListServe regarding patients under their care. RESULTS: A total of 28 eyes of 21 patients were included. Most common etiologies were thrombocytopenia, shaken baby syndrome, and birth trauma. In 9 cases (12 eyes), the vitreous hemorrhage was idiopathic. Mean time between diagnosis and surgery was 1.4 months. Complications included strabismus, cataract, glaucoma, high myopia, and retinal detachment. Recognition visual acuities were available for 8 eyes: 20/25 (2 eyes), 20/30, 20/40 (2 eyes), 20/60 (2 eyes), and 20/100. One eye had no light perception. CONCLUSIONS: The etiologies encountered in our patients were similar to those reported previously. Visual outcomes were much worse in cases with retinal complications. Other patients had better visual outcomes. Despite potential surgical and postoperative complications, this series demonstrates favorable visual outcomes can be achieved following early vitrectomy in this setting.

Nevus lipomatosus (pedunculated lipofibroma) of the eyelid.

Nevus lipomatosus is a rare connective tissue nevus characterized by mature adipose tissue within the dermis. An 11-year-old boy presented with an eyelid papule that had been observed expectantly since birth and had exhibited gradual and progressive enlargement. Excisional biopsy revealed a polypoid mass formed of mature adipocytes within the dermis and subconjunctival mucosa consistent with nevus lipomatosus. This is the first case of nevus lipomatous to our knowledge to be reported on the eyelid. Nevus lipomatous or pedunculated lipofibroma can arise on the eyelid and should be considered in the differential diagnosis of eyelid tumors.