ISSN: 2706-8870
Volume 5, Number 5 (2020)
Year Launched: 2016
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Mechanical Fall Resulting in a Retrobulbar Hematoma

Volume 5, Issue 5, October 2020     |     PP. 108-114      |     PDF (338 K)    |     Pub. Date: October 11, 2020
DOI:    191 Downloads     5153 Views  

Author(s)

Eduardo Mejia, Emergency Department, UT-Health, University of Texas Health Science Center at Houston – Medical School
Eric F. Reichman, Emergency Department, UT-Health, University of Texas Health Science Center at Houston – Medical School

Abstract
An orbital compartment syndrome is an ophthalmic emergency characterized by an acute rise in orbital pressure that can cause damage to ocular and intraorbital structures. It can result in irreversible blindness if not reversed quickly. Decompression via a lateral canthotomy and cantholysis is often required as a quick method to reduce intraorbital pressure and salvage the patient’s sight. We present a 69-year-old male who fell from standing with a left eye retrobulbar hematoma on blood thinners. The hematoma resulted in increased intraocular pressure affecting the vision. The patient symptoms were relieved with decompression. This case highlights the lateral canthotomy and cantholysis in addition to the importance of repeat eye examinations for patients with changes in symptoms. This is the first case report and second time in the literature of apixaban causing a retrobulbar hematoma.

Keywords
Compartment syndrome, Retrobulbar hemorrhage, Intraocular pressure

Cite this paper
Eduardo Mejia, Eric F. Reichman, Mechanical Fall Resulting in a Retrobulbar Hematoma , SCIREA Journal of Clinical Medicine. Volume 5, Issue 5, October 2020 | PP. 108-114.

References

[ 1 ] Bailey WK, Kuo PC, Evans LS. Diagnosis and treatment of retrobulbar hemorrhage. J Oral Maxillofac Surg 1993;51:780-2.
[ 2 ] Amer E, El-Rahman. Ocular compartment syndrome and lateral canthotomy procedure. J Emerg Med 2019;56(3):294-7.
[ 3 ] Carrim ZI, Anderson IWR, Kyle PM. Traumatic orbital compartment syndrome: importance of prompt recognition and management. Europ J Emerg Med 2007;14:174-6.
[ 4 ] Shek KC, Chung KL, Kam CW, Yau HH. Acute retrobulbar hemorrhage: an ophthalmic emergency. Emerg Med Austral 2006;18:299-301.
[ 5 ] Ballard SR, Ezenauer RW, O’Donnell T, Fleming JC, Risk G, Waite AN. Emergency lateral canthotomy and cantholysis: a simple procedure to preserve vision from sight threatening orbital hemorrhage. J Spec Ops Med 2009; 9:26-9.
[ 6 ] Blandford AD, Young JM, Arepalli S, Li A, Hwang CJ, Perry JD. Paracanthal “one-snip” decompression in a cadaver model of retrobulbar hemorrhage. Ophthal Plast Reconstr Surg 2018;34:428–31.
[ 7 ] Roque PJ, Hatch N, Barr L, Wu TS. Bedside ocular ultrasound. Crit Care Clin 2014; 30:227-41.
[ 8 ] Tyler MA, Citardi MJ, Yao WC. Management of retrobulbar hematoma. Operative Tech Otolaryngol 2017;28:208-12.
[ 9 ] Berg BI, Flury E, Thieringer FM, et al. Retrobulbar haematoma in the era of anticoagulants. Injury 2019;50:1641-1648.