Ultrasound Identification of Retrobulbar Hematomas by Emergency Physicians in a Cadaveric Model

Carlin, Edward; A, Palmieri; Bajaj, Tanya; Nelson, Mathew

doi:10.5811/westjem.2020.1.45081

Cited by 3 publications

(5 citation statements)

References 8 publications

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“…53 A recent cadaveric study by Carlin et al showed that emergency physicians at a variety of training levels can correctly identify retrobulbar hematoma with 87% sensitivity and 88% specificity. 54 Furthermore, globe rupture may or may not be detected by ultrasound. 55 Although more challenging to perform for most emergency physicians, retinal ischemia can also be diagnosed with color flow doppler and pulsed wave doppler.…”

Section: Pitfall #3 -Overreliance On Imagingmentioning

confidence: 99%

Orbital compartment syndrome: Pearls and pitfalls for the emergency physician

et al. 2021

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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. We recommend adequate preparation for the diagnosis and procedure, early consultation to ophthalmology, clear and thorough documentation of the physical examination, avoidance of iatrogenic injury during LCIC, and complete division of the inferior canthal tendon. Emergency physicians should avoid failing to make the diagnosis of OCS, delaying definitive surgical treatment, overrelying on imaging, failing to decrease intraocular pressure, and failing to exclude globe rupture. The emergency physician should be appropriately trained to identify signs and symptoms of OCS and perform LCIC in a timely manner.

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Section: Pitfall #3 -Overreliance On Imagingmentioning

confidence: 99%

Orbital compartment syndrome: Pearls and pitfalls for the emergency physician

et al. 2021

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“…Indications such as retinal and vitreous detachment, vitreous hemorrhage, and increased intracranial pressure are well studied and described in the literature and are easily utilized by the emergency physician. [7][8][9][10][11] Other uses such as foreign body and lens dislocation, which have high sensitivity and specificity in smaller studies, may be less familiar to the average emergency physician. 10 Few case reports have described the use of This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.…”

Section: Introductionmentioning

confidence: 99%

“…When performed by a trained practitioner, sonography of the eye can be helpful in diagnosing several conditions. Indications such as retinal and vitreous detachment, vitreous hemorrhage, and increased intracranial pressure are well studied and described in the literature and are easily utilized by the emergency physician 7–11 . Other uses such as foreign body and lens dislocation, which have high sensitivity and specificity in smaller studies, may be less familiar to the average emergency physician 10 .…”

Section: Introductionmentioning

confidence: 99%

Point‐of‐care ultrasound in the detection of central retinal artery occlusion in a patient with recent COVID‐19

2022

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“…14 The overall sensitivity and specificity to diagnose retrobulbar fluid were respectively 87% and 88% in a cadaveric study. 15 Orbital emphysemas are usually benign conditions more frequently related to fractures of the orbital floor and medial wall. Tears in the nasal mucosa and blocking of the exit of air by orbital soft tissues can create a valve mechanism.…”

mentioning

confidence: 99%

“…Ultrasonography may also suggest this diagnosis when showing a conical deformation of the posterior ocular globe (“guitar pick” sign) 14 . The overall sensitivity and specificity to diagnose retrobulbar fluid were respectively 87% and 88% in a cadaveric study 15 …”

mentioning

confidence: 99%

Traumatic Orbital Compression Syndromes: A Comprehensive Study Into Etiologies, Intervention Strategies, and Clinical Outcomes

Dos Santos,

Gorla,

Moreno

et al. 2024

Journal of Craniofacial Surgery

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Facial fractures and their historical link to potential blindness have been well-documented, often attributed to optic canal injuries or retinal vascular occlusion. This dire consequence can result from both direct and indirect ocular trauma, including retrobulbar hemorrhage. Traumatic orbital compression can manifest in various forms, such as hematomas, fractured bone fragments, and emphysema, all posing a significant threat to vision, necessitating immediate intervention. In this study, 9 clinical cases of traumatic orbital compression are presented, each characterized by distinct etiologies. The study delves into traumatic orbital compressive syndromes, underscoring the critical imperative of early recognition and treatment to prevent vision loss. Orbital compression, whether from edema, hematoma, or emphysema, collectively culminates in elevated intraorbital pressure and the potential for optic nerve ischemia. Through the presentation of these 9 clinical cases, the article emphasizes the pressing need for timely intervention in addressing orbital compressive syndromes to avert vision loss. Various surgical techniques are elucidated, highlighting the pivotal role of expeditious medical intervention. This article offers invaluable insights into the diagnosis, management, and outcomes of traumatic orbital compressive syndromes.

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Ultrasound Identification of Retrobulbar Hematomas by Emergency Physicians in a Cadaveric Model

Cited by 3 publications

References 8 publications

Orbital compartment syndrome: Pearls and pitfalls for the emergency physician

Orbital compartment syndrome: Pearls and pitfalls for the emergency physician

Point‐of‐care ultrasound in the detection of central retinal artery occlusion in a patient with recent COVID‐19

Traumatic Orbital Compression Syndromes: A Comprehensive Study Into Etiologies, Intervention Strategies, and Clinical Outcomes

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