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Ophthalmic Plast Reconstr Surg 2022 Jun 14. Epub 2022 Jun 14.

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

A 62-year-old man presented with diffuse, painless, left-sided preseptal edema, erythema, and woody induration extending to the left temple. The induration generated an orbital compartment syndrome with markedly elevated intraocular pressure necessitating lateral canthotomy and cantholysis. Although atypical for an infectious etiology, empiric broad-spectrum intravenous antibiotics were initiated with no improvement. Read More

Ulus Travma Acil Cerrahi Derg 2022 May;28(5):711-713

Department of Ophthalmology, İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul-Turkey.

After infratrochlear nerve block for nasolacrimal probing, sudden vision loss, proptosis, pain, loss of light reflexes, and a total limitation of ocular movement was observed in a 71-year-old female patient. She was diagnosed with retrobulbar hemorrhage and orbital compartment syndrome (OCS). Lateral canthotomy, cantholysis, and medial orbitotomy were performed on the patient. Read More

Dis Mon 2022 Apr 18:101369. Epub 2022 Apr 18.

Vanderbilt Eye Institute, Vanderbilt University Medical Center, Nashville, Tennessee, United States.

Am J Ophthalmol Case Rep 2022 Jun 3;26:101510. Epub 2022 Apr 3.

Department of Ophthalmology, Hamilton Eye Institute, University of Tennessee Health Science Center, Memphis, TN, USA.

Purpose: To report an unusual case of spontaneous orbital hemorrhage in the setting of DIC and hepatic failure.

Observations: A 33-year-old female presented to the Emergency Department (ED) with acute liver failure. During the first week of her hospital admission, she developed unilateral eyelid swelling and proptosis, prompting a consult to ophthalmology. Read More

Emerg Med Australas 2022 06 16;34(3):428-433. Epub 2022 Apr 16.

LifeFlight Retrieval Medicine, Brisbane, Queensland, Australia.

Objective: Orbital compartment syndrome (OCS) is a time critical condition, with ischaemic complications occurring after 90-120 min. In the prehospital setting, the diagnosis and management of OCS is challenging due to complex environmental considerations, competing clinical priorities, and limited equipment. This study aims to provide learning points on performing lateral canthotomy and cantholysis (LCC) in the prehospital setting. Read More

Ugeskr Laeger 2022 01;184(4)

Afdeling for Øre-Næse-Halskirurgi og Audiologi, Københavns Universitetshospital - Rigshospitalet.

Increased pressure in the orbital compartment is a medical emergency requiring immediate surgical intervention. Treatment should be initiated within the first hour to avoid permanent visual loss. This review describes the findings of orbital compartment syndrome and the procedure of performing lateral canthotomy and cantholysis. Read More

Oral Maxillofac Surg 2022 Jan 27. Epub 2022 Jan 27.

Private Practice, Athens, Greece.

Purpose: Blindness in craniomaxillofacial (CMF) injuries may occur due to acute orbital compartment syndrome (AOCS). Primarily, this article aimed to retrospectively review our 4-year experience in the management of patients diagnosed with AOCS secondary to an orbital hematoma (OH). Furthermore, this paper included up-to-date information regarding the prevalence, diagnosis, management, and prognosis of AOCS. Read More

Facial Plast Surg 2021 Dec 14. Epub 2021 Dec 14.

Department of Plastic, Reconstructive and Cranio-Maxillo-Facial Surgery, Hotel Dieu de France University Hospital, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon.

Orbital compartment syndrome (OCS) is an emergency that complicates intra-orbital, retrobulbar hemorrhage in most cases. Bony orbital decompression is an effective treatment for OCS, and displaced orbital fractures are protective. Nevertheless, in rare cases, OCS occurs despite a displaced orbital fracture. Read More

Lakartidningen 2021 Dec 13;118. Epub 2021 Dec 13.

överläkare, PhD, ögonkliniken, Skånes universitetssjukhus.

The purpose of this article is to highlight the importance of appropriate management of acute orbital trauma, in order to prevent permanent impaired vision and double vision. Orbital blowout fractures with entrapment, so-called trapdoor fractures, occur more often in children than in adults, and require immediate surgical intervention. A blowout fracture with impingement, so-called open door fracture, does not require immediate intervention. Read More

Spec Care Dentist 2022 May 4;42(3):304-307. Epub 2021 Nov 4.

TOC Eye and Face, Austin, Texas, USA.

Retrobulbar hemorrhage (RBH) refers to hemorrhage within the bony orbital cavity and most commonly results from periorbital surgery or trauma. RBH following tooth extraction is a rare occurrence. Patients with RBH will endorse symptoms of periorbital pain, double vision, or vision loss, and present with evidence of proptosis, chemosis, or subconjunctival hemorrhage. Read More

Ugeskr Laeger 2021 09;183(39)

Orbital compartment syndrome is an uncommon complication of trauma to the eye and its surroundings or a rare complication to sinus surgery. Nevertheless, it is important to diagnose and treat the condition urgently as it may cause irreversible visual impairment. In this case report, we describe a 29-year-old male suffering from a blunt trauma to the eye. Read More

Ear Nose Throat J 2022 Feb 23;101(2_suppl):43S-49S. Epub 2021 Sep 23.

Department of Ophthalmology, 12312Drexel University College of Medicine, Philadelphia, PA, USA.

Objective: To test the applicability of a fresh tissue model for teaching facial plastic techniques and approaches to the eyelids and orbit.

Design: Observational animal experiments.

Subjects: Ten prepubescent sheep heads harvested following humane euthanasia at the completion of unrelated live animal research. Read More

Craniomaxillofac Trauma Reconstr 2021 Sep 29;14(3):246-253. Epub 2020 Oct 29.

Department of Oral and Maxillofacial Surgery, Universidad de Chile, Santiago, Chile.

Study Design: A descriptive-observational study of a series case report of patients diagnosed with orbito-zygomatic complex (OZMC) fracture with lateral wall involvement, was conducted. All patients were assessed in the Oral and Maxillofacial Surgery Service at Hospital El Carmen, Maipu, Santiago, Chile.

Objective: The purpose of this study was to evaluate a single-institution experience with the transconjunctival approach to the orbit, utilizing a lateral skin extension as unique approach to access to fronto-zygomatic suture, infraorbital rim and/or orbital floor. Read More

Cureus 2021 Jul 20;13(7):e16514. Epub 2021 Jul 20.

Emergency Medicine, University of Central Florida College of Medicine, Orlando, USA.

Orbital compartment syndrome (OCS) is a rare ophthalmic surgical emergency in the setting of increased intraocular pressure (IOP) Irreversible vision loss can occur without immediate surgical treatment consisting of lateral cantholysis. We present a case of acute OCS discovered after cardiopulmonary resuscitation (CPR) with subsequent immediate lateral canthotomy and notable decrease in IOP. This in part demonstrates the importance of recognizing the clinical signs of OCS with or without trauma in the emergency department in addition with preparedness to perform a vision-saving procedure. Read More

Indian J Ophthalmol 2021 Sep;69(9):2385-2388

Department of Ophthalmology, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom.

Purpose: Retrobulbar hemorrhage from trauma is the most common cause of orbital compartment syndrome. Emergency canthotomy and cantholysis is a vision-saving procedure. We sought to identify confidence among ophthalmic trainees in this procedure as well as any relevant factors that have any impact. Read More

BMJ Case Rep 2021 Aug 5;14(8). Epub 2021 Aug 5.

Emergency Department, University Hospitals of Leicester NHS Trust, Leicester, UK

An 8-year-old girl presented to the paediatric emergency department 3 days after left orbital exploration for an orbital floor fracture. She had been vomiting for the last 24 hours and her mother's primary reason for presentation was that she was unable to keep down any analgesia . She reported pain in that eye and was unable to see. Read More

Indian J Ophthalmol Case Rep 2021 Apr-Jun;1(2):383-385. Epub 2021 Apr 1.

Department of Ophthalmology, New York University, New York, NY, USA.

A 32-year-old female with a right frontal lobe glioma underwent an elective frontotemporal craniotomy. One hour postoperatively, the patient developed a right orbital compartment syndrome (OCS) with unilateral acute vision loss, proptosis, afferent pupillary defect, and complete ophthalmoplegia. The patient underwent emergent lateral canthotomy and inferior cantholysis. Read More

J Craniofac Surg 2022 Jan-Feb 01;33(1):e16-e17

Department of Oral and Maxillofacial Surgery (Head: Iron Snidei, MD, DDS), Osasco Regional Hospital SUS/SP Osasco.

Abstract: Displaced fractures of the zygomatic bone that require surgical treatment are accessed transcutaneously but these accesses to the skin can cause a hypertrophy scar in patients with this predisposition. This paper indicates a modification in the lateral canthotomy that aim to minimize the hypertrophic scar in the treatment of zygomatic fracture. Read More

J Pediatr Hematol Oncol 2022 01;44(1):e302-e305

Department of Child Health, Division of Pediatric Hematology-Oncology.

Spontaneous retrobulbar hemorrhage is a rare yet vision-threatening condition. We reported a 5-month-old male infant with sudden onset of left eye proptosis with no prior history of getting vitamin K injection after birth. Head computed tomography scan revealed retrobulbar and intracranial hemorrhages. Read More

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 Jun 13;60(6):777-780. 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 2021 07 31;45:686.e1-686.e4. 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 2022 Apr 22;41(2):193-198. Epub 2020 Dec 22.

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

Purpose: 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.

Methods: 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 2021 Jun;32(4):e337-e340

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

Abstract: 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