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Scars Burn Heal 2021 Jan-Dec;7:20595131211006659. Epub 2021 Apr 14.

Burn Center, Department of Plastic- and Maxillofacial Surgery, Uppsala University Hospital, Uppsala, Sweden.

Introduction: Ophthalmological complications such as orbital compartment syndrome (OCS) and ischemic optic neuropathy are rare complications in patients with burns and have been described in patients where aggressive fluid resuscitation was performed. While OCS requires urgent surgical intervention, no current treatment is established to treat, or prevent, ischemic optic neuropathy in patients with burns.

Methods: The authors report a case of a 38-year-old woman with flame burns including the periorbital regions who developed OCS on the left side and anterior ischemic optic neuropathy (AION) on the right side despite non-aggressive fluid resuscitation. Read More

Ann Transl Med 2021 Mar;9(6):463

Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China.

Background: Compared to isolated orbital wall fracture, combined orbital floor and medial wall fractures are more likely to be required surgical correction due to a higher possibility of complications. However, it remains a challenge to repair concomitant orbital fracture using a one-piece implant due to the complex anatomic structures of the orbit. Aiming to reduce surgical difficulties and enhance therapeutic effects, we repaired unilateral combined orbital floor and medial wall fractures using two separated modified titanium mesh plates in this study. Read More

J Am Coll Emerg Physicians Open 2021 Apr 6;2(2):e12372. Epub 2021 Mar 6.

Mercy Health St. Vincent Medical Center Toledo Ohio USA.

Orbital compartment syndrome (OCS) is a rare, vision-threatening diagnosis that requires rapid identification and immediate treatment for preservation of vision. Because of the time-sensitive nature of this condition, the emergency physician plays a critical role in the diagnosis and management of OCS, which is often caused by traumatic retrobulbar hemorrhage. In this review, we outline pearls and pitfalls for the identification and treatment of OCS, highlighting lateral canthotomy and inferior cantholysis (LCIC), a crucial skill for the emergency physician. Read More

Case Rep Ophthalmol 2021 Jan-Apr;12(1):68-72. Epub 2021 Jan 14.

Department of Oculoplastic, Orbital and Lacrimal Surgery, Aichi Medical University Hospital, Nagakute, Japan.

In the classic loop myopexy (Yokoyama) procedure, muscle belly union in the deep orbit is technically difficult, particularly in patients with deep-set eyes and narrow palpebral fissures. Our modified procedure includes a lateral canthotomy and cantholysis and upper conjunctival fornix incisions to facilitate this step. Read More

J Emerg Med 2021 Feb 13. Epub 2021 Feb 13.

Department of Emergency Medicine, Denver Health and Hospital Authority, University of Colorado School of Medicine, Denver, Colorado.

Background: Lateral canthotomy is a vision-saving procedure. However, the low incidence of orbital compartment syndrome and the expense of simulators to practice this procedure can lead to low confidence and delays in the performance of the procedure by emergency physicians.

Discussion: We used a simple, inexpensive, easily assembled eye model for lateral canthotomy education at a residency program and a national conference obtaining feedback from simulation participants. Read More

J Emerg Med 2021 Apr 19;60(4):520-523. Epub 2021 Jan 19.

Boston University School of Medicine, Boston, Massachusetts; Department of Emergency Medicine, Boston Medical Center, Boston, Massachusetts.

Background: Superior orbital fissure syndrome (SOFS) is a rare constellation of findings consisting of ophthalmoplegia, ptosis, a fixed dilated pupil, forehead anesthesia, and loss of the corneal reflex. This syndrome, though rare, is most often encountered in trauma with individuals sustaining a facial fracture.

Case Report: We present a case of a young woman who was diagnosed with SOFS after a fall in her house, hitting her face on a nightstand. Read More

Am J Emerg Med 2020 Dec 31. Epub 2020 Dec 31.

Spectrum Health - Michigan State University Emergency Medicine Residency Program, Grand Rapids, MI, USA. Electronic address:

Traumatic tension pneumocephalus and orbital compartment syndrome are rare, tend to be associated with severe craniofacial injuries, and can occur following both blunt and penetrating injury. Early recognition and high index of clinical suspicion are important in both cases. Emergency decompression results in improvement in vast majority of cases. Read More

Orbit 2020 Dec 22:1-6. Epub 2020 Dec 22.

Ophthalmic Plastic Surgery Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA.

: To compare the incidence of lower eyelid malposition following repair of isolated orbital floor fractures with that of complex orbitofacial fractures (defined as multi-wall fractures or prior orbital fracture repairs requiring revision) by oculofacial plastic surgeons via a transconjunctival or swinging eyelid approach.: Retrospective review of 175 patients who underwent surgical repair of orbital fractures at our institution. The primary outcomes were the occurrence of lower eyelid malposition (ectropion, entropion, and eyelid retraction) and the need for subsequent surgical correction. Read More

J Emerg Med 2021 Mar 7;60(3):377-379. Epub 2020 Dec 7.

Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.

Background: Orbital compartment syndrome (OCS) is an ocular emergency that can severely threaten the visual potential. The most common etiologies include facial trauma-related orbital wall fractures and postoperative bleeding within the orbit. Nontraumatic cases were also reported sporadically, although they are rare. Read More

J Craniofac Surg 2020 Nov 10. Epub 2020 Nov 10.

Department of Ophthalmology and Vision Sciences, Sunnybrook Health Sciences Centre.

Carotid-cavernous fistulas (CCFs) are abnormal connections between the carotid arterial system and the cavernous sinus. These acquired vascular malformations may result in severe orbital congestion and sight-threatening complications. The authors present their experience in gaining access to the superior ophthalmic vein to embolize indirect CCFs in three different patients. Read More

Ophthalmic Plast Reconstr Surg 2020 Oct 16. Epub 2020 Oct 16.

Department of Ophthalmology, University of Texas Medical Branch, Galveston, Texas*Baylor College of Medicine, Houston, Texas, U.S.A.

Orbital compartment syndrome is an ophthalmologic emergency that requires timely surgical intervention. The authors present a rare case of orbital compartment syndrome in a 30-year-old male injured by forceful entry of air-gasoline mixture into the orbit, secondary to inadvertent firing of the piston from running mechanical diagnostics on an automobile internal combustion engine. Orbital CT revealed extensive orbital emphysema with both pre- and postseptal involvement and diffuse chemical cellulitis. Read More

J Neurol Surg B Skull Base 2020 Aug 7;81(4):435-441. Epub 2020 Aug 7.

Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States.

The lateral orbitotomy approach (LOA) was first described by Kronlein in 1888 and has since been subject to many modifications and variations. When considering orbital approaches, the location of the pathology is often more important in decision making than the type of pathology. The LOA is best suited for access to intraconal and extraconal lesions lateral to the optic nerve. Read More

J Burn Care Res 2021 Mar;42(2):193-199

Division of Plastic and Reconstructive Surgery, University of Toronto, Ontario, Canada.

Orbital compartment syndrome (OCS) is a rare but devastating complication of over-resuscitation in burn patients that may lead to permanent visual loss. The purpose of this study was to 1) present a series of burn patients with OCS and 2) survey practice patterns of monitoring intra-ocular pressure (IOP) during burn resuscitation. Cases of OCS at two American Burn Association (ABA)-verified burn centers were retrospectively reviewed. Read More

Orbit 2021 Jun 27;40(3):222-227. Epub 2020 May 27.

Department of Ophthalmology and Visual Sciences, University of Louisville, Louisville, Kentucky, USA.

: To compare the efficacy of the vertical lid split (VLS) to the standard lateral canthotomy and cantholysis (LC/C) for orbital compartment syndrome (OCS) in the cadaveric model.: Simulated OCS was achieved in seven fresh frozen cadaveric orbits. Orbital pressure (OP) was monitored in one control orbit and six interventional orbits. Read More

World Neurosurg 2020 07 25;139:588-591. Epub 2020 Apr 25.

Division of Neurosurgery, Department of Surgery, Uniformed University of the Health Sciences, Bethesda, Maryland, USA. Electronic address:

Background: Orbital compartment syndrome (OCS) is a rare post operative complication of Neurosurgery. It presents typically acutely with loss of vision, loss of pupillary reaction, and limitation of extraocular movement. The etiology of OCS is most typically associated with increased pressure from a mass lesion in the orbit compromising the blood supply of orbital structures. Read More

Am J Emerg Med 2020 06 9;38(6):1278-1280. Epub 2019 Dec 9.

Department of Ophthalmology and Visual Sciences, University of Iowa, Carver College of Medicine, United States of America. Electronic address:

Orbit 2020 Dec 7;39(6):446-449. Epub 2020 Jan 7.

Department of Pathology, Kasturba Medical College, Manipal Academy of Higher Education , Manipal, India.

Perineurioma is a rare benign soft tissue tumor arising from the peripheral nerve sheath. To date only two cases of orbital perineurioma have been reported in literature. A 45-year-old, with no comorbidities, presented with protrusion of the right eye since one-year. Read More

Clin Ophthalmol 2019 7;13:2189-2194. Epub 2019 Nov 7.

Oxford Eye Hospital, John Radcliffe Hospital, Oxford, UK.

Orbital compartment syndrome (OCS) is a potentially blinding condition characterized by a rapid increase in intra-orbital pressure. OCS is most commonly seen in the context of intra-orbital hemorrhage secondary to either trauma or surgery. A review of the literature indicates that better visual outcomes are achieved when interventions occur within the first 2 hrs. Read More

Int Forum Allergy Rhinol 2020 03 27;10(3):412-418. Epub 2019 Nov 27.

Department of Otolaryngology-Head & Neck Surgery, Western University, London, ON, Canada.

Background: Retrobulbar hematoma (RH) is a rare but devastating complication of sinus surgery. It is treated initially with a lateral canthotomy and cantholysis at the bedside. Due to the high stakes and urgency of this complication, teaching this in the clinical setting is difficult. Read More

Ophthalmic Plast Reconstr Surg 2019 Nov/Dec;35(6):586-589

Ruiz Department of Ophthalmology and Visual Science, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth).

Purpose: Evaluate visual outcomes in relation to time from injury to intervention in patients who undergo lateral canthotomy with cantholysis (LCC) for retrobulbar hemorrhage (RBH).

Methods: Retrospective study of patients with orbital compartment syndrome (OCS) secondary to RBH who underwent LCC. OCS due to RBH was defined by a combination of decreased vision, proptosis, resistance to retropulsion, increased intraocular pressure, and relative afferent pupillary defect. Read More

Nepal J Ophthalmol 2019 Jan;11(21):91-97

Vasan Eye Care, Lakshmipuram, India.

Orbital compartment syndrome is a rare presentation of orbital trauma and is an ophthalmic emergency. Delay in clinical diagnosis and subsequent surgical intervention will lead to loss of vision in nick of time. We presented a case series of orbital compartment syndrome secondary to trauma who presented to the emergency department of Tribhuvan University Teaching Hospital during the devastating earthquake in April 2015. Read More

Cureus 2019 Jul 1;11(7):e5057. Epub 2019 Jul 1.

Emergency Medicine, Mercer University School of Medicine, Macon, USA.

In the following case presentation, a young man who incurred orbital compartment syndrome (OCS) from physical trauma significantly improved from timely lateral canthotomy. Lateral canthotomy is recommended to be performed as soon as possible to avoid permanent vision loss, which is the most feared complication associated with orbital compartment syndrome. This procedure completely restored vision in the patient and permitted prompt discharge. Read More

Graefes Arch Clin Exp Ophthalmol 2019 Nov 5;257(11):2541-2545. Epub 2019 Sep 5.

Department of Ophthalmology, San Antonio Military Medical Center, 3551 Roger Brooke Drive, San Antonio, TX, 78234, USA.

Background: Orbital roof fractures are a significant cause of morbidity in trauma and are associated with a spectrum of orbital and ocular injuries. This study aims to characterize orbital roof fracture patterns and quantify the rate of acute intervention as compared with non-roof involving orbital wall fractures.

Methods: This study is a retrospective analysis of 340 orbital wall fractures diagnosed by CT imaging from August 2015 to October 2016. Read More

Klin Monbl Augenheilkd 2019 Aug 15. Epub 2019 Aug 15.

Zentrum für Augenheilkunde, Universität zu Köln, Medizinische Fakultät und Uniklinik Köln, Köln.

Retrobulbar haematoma (RBH) is a rare complication that may affect vision after a trauma or a surgical procedure. The diagnosis must be made promptly, as only early surgical intervention can adequately prevent irreversible visual impairment. Because of the bony orbital walls, there is hardly any room for the increasing intraorbital volume due to the retrobulbar haemorrhage. Read More

Acta Neurochir (Wien) 2019 09 29;161(9):1919-1929. Epub 2019 Jun 29.

Department of Neurological Surgery, Tri-Service General Hospital, National Defense Medical Center, No. 325, Section 2, Cheng-Kung Road, Neihu, 114, Taipei, Taiwan, Republic of China.

Background: Endoscopic transorbital approach (eTOA) has been announced as an alternative minimally invasive surgery to skull base. Owing to the inferior orbital fissure (IOF) connecting the orbit with surrounding pterygopalatine fossa (PPF), infratemporal fossa (ITF), and temporal fossa, the idea of eTOA to anterolateral skull base through IOF is postulated. The aim of this study is to access its practical feasibility. Read More

Int Med Case Rep J 2019 30;12:125-134. Epub 2019 Apr 30.

Oculoplastic and Reconstruction Division, Department of Ophthalmology, Phramongkutklao Hospital, Phramongkutklao College of Medicine, Bangkok, Thailand.

Orbital cellulitis is an infection of the ocular adnexal and orbital tissues behind the orbital septum. The complications are poor prognosis. This paper is to describe some severe rare complications of orbital cellulitis. Read More

Orbit 2020 Apr 20;39(2):87-92. Epub 2019 May 20.

Department of Ophthalmology and Visual Sciences, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.

: To evaluate a human cadaveric model in improving knowledge and comfort of ophthalmology residents performing a lateral canthotomy/cantholysis.: A prospective study was conducted in ophthalmology residents, who participated in a workshop including an interactive lecture followed by hands-on training on a human cadaver. The lecture consisted of the indications and techniques of lateral canthotomy/cantholysis, along with video-demonstration of proper technique. Read More

Br J Oral Maxillofac Surg 2019 06 17;57(5):488-490. Epub 2019 Apr 17.

Adnexal Department, Moorfields at St Georges Hospital, Tooting, London, United Kingdom.