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Cesk Slov Oftalmol 2023 ;79(4):170-176

Aims: The aim of this study is to retrospectively evaluate the use of a transconjunctival surgical approach in maxillofacial surgery on the fractures of the infraorbital rim and the orbital floor by analyzing the operating time, the incidence of perioperative and postoperative complications, as well as the functional and aesthetic outcomes of transconjunctival surgical treatment.

Materials And Methods: All the patients on whom we used a transconjunctival approach from December 2017 to December 2021 were included in this retrospective study. The epidemiological causes of fractures of the midface skeleton were analyzed. Read More

Retin Cases Brief Rep 2023 Jul;17(4):455-458

Department of Ophthalmology and Visual Sciences, McGill University, Jewish General Hospital, Montreal, Quebec, Canada.

Purpose: The authors report the emergent management of a case of orbital and parapharyngeal emphysema causing orbital compartment syndrome and signs of peripheral neuropathy days after pars plana vitrectomy.

Methods: Case report.

Results: A 20-year-old woman underwent 3-port 23-gauge pars plana vitrectomy in the right eye for total retinal detachment under general anesthesia. Read More

Plast Reconstr Surg Glob Open 2023 May 22;11(5):e5014. Epub 2023 May 22.

From the Division of Plastic and Reconstructive Surgery, The Warren Alpert Medical School of Brown University, Providence, R.I.

The transconjunctival incision is a common and effective approach for establishing surgical exposure to the orbital floor. When access to the lateral orbit is also required, this incision may be extended by an accompanying lateral canthotomy, which releases the tarsal plates from the conjunctiva. Although this approach broadens surgical access through a simple extension, it is often remarked for unpredictable healing patterns and negative aesthetic sequelae, such as rounding of the lateral canthal angle. Read More

SAGE Open Med Case Rep 2023 19;11:2050313X231180725. Epub 2023 Jun 19.

Plastic Surgery Service, Department of Surgery, Facultad de Medicina y Hospital Universitario "Dr. Jose Eleuterio Gonzalez," Universidad Autonoma de Nuevo Leon, Monterrey, Mexico.

Herpesvirus reactivates from a latent infection in older adults and critically ill and immunocompromised individuals. Herpes zoster ophthalmicus (HZO) is a latent infection that affects the fifth cranial nerve. It is an infrequent cause of increased intraocular pressure. Read More

Air Med J 2023 31;42(4):303-306. Epub 2023 Mar 31.

Department of Emergency Medicine, University of Cincinnati College of Medicine, Cincinnati, OH; UC Health Air Care & Mobile Care, Cincinnati, OH. Electronic address:

Objective: Lateral canthotomy is a rare, emergent, vision-preserving procedure to treat orbital compartment syndrome. Using Ericsson's deliberate practice model, we aimed to develop a multimodal small group intervention including a modified low-fidelity task trainer to improve flight physician knowledge and technical competency for lateral canthotomy in the prehospital context.

Methods: Two cohorts of resident (postgraduate year 1) flight physicians received small group training during an all-day competency-based flight physician orientation. Read More

Am J Emerg Med 2023 Aug 1;70:140-143. Epub 2023 Jun 1.

Department of Ophthalmology, University of Washington, 908 Jefferson St Building, 7th Floor, Seattle, WA 98104, United States of America.

Purpose: Vision loss after facial trauma can occur from orbital compartment syndrome (OCS). Orbital compartment syndrome is commonly treated surgically with a lateral canthotomy and cantholysis (C&C). Our study investigates success rates of lateral C&C for the treatment of OCS amongst emergency medicine (EM) and ophthalmology providers. Read More

Ophthalmic Plast Reconstr Surg 2023 Jul-Aug 01;39(4):e115-e117. Epub 2023 Mar 9.

University of Iowa Department of Ophthalmology and Visual Sciences, University of Iowa.

A 66-year-old immunocompromised man presented with cellulitis around the left eye that was initially concerning for necrotizing fasciitis. Exam findings were remarkable for exquisite periocular tenderness with rigid, immobile eyelids resulting from severe erythema, edema, and induration. Given the concern for orbital compartment syndrome and a necrotizing infection, the patient was taken urgently to the operating room for debridement of the eyelid skin as well as an urgent lateral canthotomy and cantholysis. Read More

Ophthalmic Plast Reconstr Surg 2023 Jul-Aug 01;39(4):341-346. Epub 2022 Nov 17.

Department of Ophthalmology, University of Colorado, Aurora, Colorado, U.S.A.

Purpose: Severe burn patients require high-volume fluid resuscitation, which increases risk for orbital compartment syndrome (OCS). We aimed to understand surgeons' practice patterns and to examine risk factors for OCS, timing of lateral canthotomy and cantholysis (LCC), and complications of intervention.

Methods: A survey of American Society of Ophthalmic Plastic and Reconstructive Surgery and North American Society of Academic Orbital Surgeons' practice patterns in burn patients was undertaken. Read More

Orbit 2022 Dec 27:1-3. Epub 2022 Dec 27.

Adnexal Department, Moorfields Eye Hospital NHS Trust, London, UK.

A patient was treated with tear trough filler and developed a retrobulbar haemorrhage. This was managed acutely with a lateral canthotomy and cantholysis with no lasting visual compromise. This is the first reported case of an orbital compartment syndrome following filler injection and highlights the potential blinding complications which can occur. Read More

Am J Emerg Med 2023 Feb 21;64:206.e1-206.e3. Epub 2022 Nov 21.

University of Washington School of Medicine, United States of America; Elson S. Floyd College of Medicine, United States of America; Northwest Eyelid & Orbital Specialists, United States of America.

Orbital compartment syndrome is a rare but serious condition most commonly as a result of traumatic retrobulbar hemorrhage and must be treated quickly to avoid ischemic damage to the optic nerve and retina. While the previously accepted standard of care for management of this condition has been lateral canthotomy with inferior cantholysis, this procedure can be challenging for physicians to perform given the rarity of the condition and that patients are frequently in significant pain often with significant periocular edema. In this case, orbital compartment syndrome was effectively treated with a paracanthal "one-snip" incision quickly and efficiently in the ED. Read More

Neurohospitalist 2023 Jan 22;13(1):78-81. Epub 2022 Jun 22.

Cerebrovascular Center, Cleveland Clinic, Cleveland, OH, USA.

Subperiosteal orbital hemorrhage usually occurs in the setting of facial or orbital trauma. Non-traumatic subperiosteal orbital hemorrhage (NTSOH) has rarely been reported in literature. The proposed mechanism of NTSOH is the transmission of sudden increase in cranial venous pressure to the orbital veins, which are valveless. Read More

Mil Med 2022 Dec 3. Epub 2022 Dec 3.

Department of Surgery, Uniformed Services University of the Health Sciences and the Walter Reed National Military Medical Center, Bethesda, MD 20814, USA.

Introduction: Preservation of life, preservation of limb, and preservation of eyesight are the priorities for military medical personnel when attending to casualties. The incidences of eye injuries in modern warfare have increased significantly, despite personal eye equipment for service members. Serious eye injuries are often overlooked or discovered in a delayed fashion because they accompany other life- and limb-threatening injuries, which are assigned a higher priority. Read More

Indian J Otolaryngol Head Neck Surg 2022 Oct 29;74(Suppl 2):1023-1027. Epub 2020 Aug 29.

Department of Ophthalmology, All India Institute of Medical Sciences, Raipur, India.

A case of 50-year-old male who presented with orbital compartment syndrome as a sequela of mid facial trauma, and literature review. Orbital compartment syndrome (OCS) is one of the potentially sight threatening emergencies encountered in clinical practice. Acute rise in pressure within the confined orbital cavity compromises the blood flow to retina and optic nerve leading to irreparable vision loss. Read More

Rhinology 2022 Dec;60(6):421-426

ENT Department, Fondazione Marchi, Varese, Italy.

Background: Intraoperative intraorbital bleeding is a rare but potentially catastrophic event that can lead even to blindness, if not treated promptly. The goal of surgery is to quickly reduce intraorbital pressure thus restoring normal visual function. Aim of our work is to propose a practical algorithm helping the surgeon in the setting of this critical event. Read More

Case Rep Ophthalmol 2022 16;13(2):626-629. Epub 2022 Aug 16.

General Ophthalmology, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia.

The objective of this report was to describe a case of total traumatic iridodialysis in the context of blunt trauma with an orbital-floor fracture. A 76-year-old female presented post-fall with right-eye blunt trauma. She underwent canthotomy and cantholysis due to concern of orbital compartment syndrome in a regional hospital with emergency physicians clearing dark tissue near the lateral canthus at the time of canthotomy cantholysis. Read More

Am J Emerg Med 2022 Oct 6;60:225.e1-225.e4. Epub 2022 Jul 6.

Arnold Palmer Hospital for Children, Orlando, FL, USA.

Orbital compartment syndrome is an ophthalmologic emergency that requires immediate intervention to preserve eyesight. This case highlights a rare, delayed presentation of orbital compartment syndrome requiring emergent lateral orbital canthotomy. Read More

Ophthalmic Plast Reconstr Surg 2022 Nov-Dec 01;38(6):e167-e170. 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

Clin Ophthalmol 2022 2;16:1365-1373. Epub 2022 May 2.

Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Purpose: To describe ophthalmology resident experience with ophthalmic trauma cases in the U.S. . 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 Sep 18;68(9):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 Jun 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

BMJ Case Rep 2022 Mar 3;15(3). Epub 2022 Mar 3.

Ophthalmology, Mater Misericordiae University Hospital, Dublin, Ireland.

A postpartum woman presented with sudden-onset left eyelid swelling and severe pain. Clinical examination revealed left exophthalmos and ophthalmoplegia with marked resistance to retropulsion of the left globe. The patient was not able to perceive light in the affected left eye and a relative afferent pupillary defect was present. Read More

Ugeskr Laeger 2022 Jan;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 2023 Mar 27;27(1):101-116. 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 2022 Jun 14;38(3):274-278. 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