injuries poisoning
Eye Contusions and Lacerations
Orbital compartment syndrome
Orbital compartment syndrome (OCS) is an ophthalmic emergency. OCS occurs when orbital pressure increases suddenly, usually due to trauma that causes orbital hemorrhage. Anything that increases orbital volume (air, blood, or pus in the orbit) can lead to an OCS. Symptoms can include sudden vision loss, as well as diplopia, eye pain, and lid swelling. Physical examination findings may include decreased vision, chemosis, ecchymosis, limited and/or painful eye motility, afferent pupillary defect, proptosis, ophthalmoplegia, and elevated intraocular pressure (IOP). Diagnosis is clinical and treatment should not be delayed for imaging. Treatment is immediate How To Do Lateral Canthotomy (surgical exposure of the lateral canthal tendon with incision of its inferior branch) followed by: Monitoring with possible inpatient hospitalization with elevation of the head of the bed to 45° Treatment of elevated IOP as in Angle-Closure Glaucoma None Reversal of any coagulopathy Prevention of further increasing intraorbital pressure (preventing or minimizing pain, nausea, cough, straining, severe hypertension) Application of ice or cool compresses Consultation with ophthalmology for consideration of surgery and/or other indicated speciality-specific treatments 