Retrobulbar Hematoma

Lateral canthotomy: Be a Nike ninja and just do it! - Anton Helman

Retrobulbar Hematoma

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EM Quick Hits: Lateral Canthotomy...

Lateral canthotomy – cantholysis

  • Time is eye; a lateral canthotomy is indicated for trauma patients with orbital compartment syndrome within 60-120 minutes of onset of ischemic features (decreased visual acuity and RAPD) as a temporizing measure to definitive surgical evacuation of the retrobulbar hematoma.
  • Clinical clues to orbital compartment syndrome include mechanical consequences (proptosis from the retrobulbar hematoma – most easily seen from the head of the bed with the patient lying supine – IOP>40mmHg and impaired extraocular movements), and ischemic consequences (decreased visual acuity, RAPD and a blown pupil)
  • Do not wait…

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Last Updated : Friday, May 27, 2022