Lateral Canthotomy and Cantholysis: Emergency Management of Orbital Compartment Syndrome

Rowh, Adam D.; Ufberg, Jacob W.; Chan, Theodore C.; Vilke, Gary M.; Harrigan, Richard A.

doi:10.1016/j.jemermed.2014.11.002

Cited by 44 publications

(30 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Return of vision has been reported after decompression suggesting return of perfusion. 1,16,19,20 Studies have shown immediate decrease in intraorbital pressure after canthotomy and cantholysis, and case reports have demonstrated the efficacy of this procedure to restore vision. [21][22][23][24] If the patient fails to show improvement, the orbit may be further decompressed by opening of the orbital septum and/or bony expansion of the orbit by removing one of the orbital walls.…”

Section: Discussionmentioning

confidence: 99%

Elevated Intraocular Pressure in Burn Patients Undergoing Fluid Resuscitation: An Opportunity to Avoid Orbital Compartment Syndrome

Shen

Woody

Fuller

et al. 2020

Journal of Academic Ophthalmology

View full text Add to dashboard Cite

Abstract Objective This study aims to discuss clinical characteristics of burn patients who developed elevated intraocular pressure (IOP). We propose management strategies to prevent orbital compartment syndrome before invasive treatment is required. Methods A retrospective review of 47 burn patients at the University of California San Diego (UCSD), Burn Intensive Care Unit (ICU; major regional burn center for San Diego county), was analyzed for demographics, fluid resuscitation volumes, and physical exam findings. Patients requiring topical treatment for high-IOP, defined as ≥30 mm Hg in either or both eyes, were compared with those who did not require treatment, using the t-test and Fisher's exact test. Linear regression tested for an association between peak IOP and fluid volume. Logistic regression evaluated the association between total fluid and treatment of high IOP, while adjusting for other characteristics. Results Six of 47 patients required IOP-lowering treatment. Of the patients requiring treatment, one drop of dorzolamide/timolol in both eyes twice daily was the most common treatment recommendation. Presence of periocular burns was a significant risk factor in patients who required treatment for high IOP. No patients developed orbital compartment syndrome or required surgical intervention to lower IOP. The mean total fluid volume delivered in the first 24 hours was 0.8 times the level prescribed by fluid resuscitation guidelines. Conclusion By treating early clinical signs and properly managing fluid resuscitation, development of orbital compartment syndrome in burn patients can be avoided.

show abstract

Section: Discussionmentioning

confidence: 99%

Elevated Intraocular Pressure in Burn Patients Undergoing Fluid Resuscitation: An Opportunity to Avoid Orbital Compartment Syndrome

Shen

Woody

Fuller

et al. 2020

Journal of Academic Ophthalmology

View full text Add to dashboard Cite

show abstract

“…The pressure exerted by the hematoma reduces perfusion resulting in ischemia-induced vision loss, which may develop over minutes to hours. 1 – 3 OCS may present with ocular pain, diplopia, or vision loss. 4 , 5 OCS is a clinical diagnosis with physical examination findings that may include ophthalmoplegia, proptosis, subconjunctival hemorrhage, and afferent pupillary defect.…”

Section: Discussionmentioning

confidence: 99%

Orbital Compartment Syndrome Following Mechanical Fall

Schwitkis

Pollack

Torbati

2018

CPC-EM

View full text Add to dashboard Cite

“…Any therapy must primarily aim for fast reduction in the intraorbital pressure. [12][13][14] Best results in depressing intraorbital pressure are achieved through lateral canthotomy and lateral cantholysis. The blade of a pair of scissors is placed horizontally from the lateral lid angle to the lateral canthal tendon and a cut is made (►Fig.…”

Section: Retrobulbar Hematomamentioning

confidence: 99%

Emergency Treatment of Ocular Trauma

Lipke

Gümbel

2015

Facial plast Surg

View full text Add to dashboard Cite

Injuries to the eye and its adnexa are common in head and neck trauma centers. An ophthalmologist experienced in ocular traumatology is not always available. Therefore, every emergency physician should be familiar with the basic evaluation, triage, and management of ocular trauma. Above all, the identification of a need for immediate treatment should be implemented in the algorithm of an emergency room, especially in a head and neck trauma center, to reduce the risk of a devastating loss of vision. This article formulates the different types of ocular trauma and their required first-line therapy.

show abstract

Lateral Canthotomy and Cantholysis: Emergency Management of Orbital Compartment Syndrome

Cited by 44 publications

References 16 publications

Elevated Intraocular Pressure in Burn Patients Undergoing Fluid Resuscitation: An Opportunity to Avoid Orbital Compartment Syndrome

Elevated Intraocular Pressure in Burn Patients Undergoing Fluid Resuscitation: An Opportunity to Avoid Orbital Compartment Syndrome

Orbital Compartment Syndrome Following Mechanical Fall

Emergency Treatment of Ocular Trauma

Contact Info

Product

Resources

About