1/9. Nontraumatic subperiosteal orbital hemorrhage.PURPOSE: Nontraumatic subperiosteal orbital hemorrhage (NTSOH) has been reported rarely in association with sudden elevation of cranial venous pressure, generalized diseases with bleeding diatheses, and paranasal sinusitis. To define more clearly the clinical and imaging characteristics of NTSOH, we evaluated nine cases seen by the authors and reviewed previous case reports. DESIGN: Retrospective, noncomparative case series. PARTICIPANTS: Nine patients (10 eyes) with NTSOH. INTERVENTION: All patients underwent computed tomography scans of the orbits. patients with typical clinical and imaging features and normal visual function were observed. Those with an uncertain diagnosis or visual compromise underwent surgical drainage of the hematoma. MAIN OUTCOME MEASURES: Resolution of proptosis, diplopia, lid swelling, and ptosis. RESULTS: Nine patients ranging from birth to 73 years of age were identified. All were females. The lesions were located superiorly in eight patients (one patient had bilateral lesions) and medially in one patient. Most were associated with sudden elevation in venous pressure (vomiting, strangulation, straining), and most required no surgical intervention. The bilateral case occurred in the setting of disseminated intravascular coagulation and was the only case associated with visual loss possibly resulting from ischemic optic neuropathy. CONCLUSIONS: Nontraumatic subperiosteal orbital hemorrhage may occur at any age, usually secondary to sudden elevation in venous pressure. It is nearly always superior. The clinical and radiologic features are sufficiently characteristic to allow conservative treatment in the absence of visual compromise.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
2/9. garlic and the strabismus surgeon.Potential side-effects caused by complementary medicines are often not anticipated. A case is reported of bilateral retro-bulbar haemorrhages with elevated intraocular pressure during strabismus surgery that occurred as a result of odourless garlic tablet ingestion prescribed by a naturopath. A near-catastrophic event was averted with rapid recognition and medical treatment. This is believed to be the first such report of haemorrhaging in ophthalmic surgery induced by garlic. It is concluded that unregulated naturopathic prescribing is potentially dangerous; doctors need to ask specifically about naturopathic potions.- - - - - - - - - - ranking = 0.33333333333333keywords = pressure (Clic here for more details about this article) |
3/9. Orbital varix rupture during cataract surgery.We report a case of orbital varix rupture during cataract surgery with retrobulbar anesthesia. No remarkable changes were observed 10 minutes after retrobulbar anesthesia was administered, but a rise in intraocular and intraorbital pressure was noted about 10 minutes after phacoemulsification began. The eyelid could not be closed at the end of surgery because of severe proptosis. Follow-up by magnetic resonance imaging and color Doppler imaging revealed orbital hemorrhage and varix. Based on the time of its appearance, the hemorrhage was thought to be the result of venous congestion caused by anesthetic agent in the muscle cone. Although intermittent exophthalmos is a symptom of orbital varix, silent orbital varix should be considered when selecting the method of anesthesia for ocular surgery.- - - - - - - - - - ranking = 0.33333333333333keywords = pressure (Clic here for more details about this article) |
4/9. Idiopathic orbital hemorrhage related to the inferior rectus muscle: a rare cause for acute-onset diplopia and unilateral proptosis.PURPOSE: To report 6 patients with spontaneous orbital hemorrhage in relation to the inferior rectus muscle. DESIGN: Retrospective observational case series. PARTICIPANTS: Six patients with acute onset orbital pain, diplopia, and proptosis referred to the orbital clinic at the Royal Victorian Eye and ear Hospital, January 1995 through December 2004. methods: review of clinical history, imaging studies, and follow-up. MAIN OUTCOME MEASURES: Resolution of proptosis and diplopia and imaging studies of the orbit, including computed tomography (CT), magnetic resonance imaging (MRI), or both. RESULTS: Six patients (4 men, 2 women; mean age, 68 years) were referred with acute onset of unilateral proptosis and diplopia. None of the patients had a history of bleeding disorder. visual acuity and intraocular pressure were normal; 3 patients showed marked limitation in upgaze on the affected side. Imaging studies of the orbit by CT, MRI, or both showed inferior orbital hemorrhage either within (4 patients) or adjacent to (2 patients) the inferior rectus muscle, possibly within the muscular sheath. Symptoms resolved completely in all but 1 patient, who had persistent diplopia in extreme upgaze. Follow-up CT, MRI, or both showed complete resolution in 3 patients and mild persistent inferior rectus muscle thickening in 2 patients. CONCLUSIONS: Acute onset proptosis and diplopia may be secondary to spontaneous orbital hemorrhage within the inferior rectus muscle or its sheath with no other orbital or systemic pathologic features. Symptoms resolved spontaneously over the course of days to weeks, and orbital imaging showed complete resolution or mild persistent enlargement of the muscle without significant symptoms.- - - - - - - - - - ranking = 0.33333333333333keywords = pressure (Clic here for more details about this article) |
5/9. Orbital subperiosteal hemorrhage while scuba diving.PURPOSE: To report an uncommon case of unilateral subperiosteal hemorrhage while scuba diving involving the orbit, a condition characterized by proptosis and associated severe ocular motility disturbances with displacement of the eyeball. MATERIAL AND methods: Observational case report. RESULTS: Unilateral subperiosteal hemorrhage in a 31-year-old woman while scuba diving at a depth of 20 meters. This was documented by clinical and radiographic examination. Computed tomography (CT) scan demonstrated a subperiosteal hemorrhage as a self-limited mass protruding into the left orbit. The process resolved without treatment and without visual or motility sequelae. A CT-scan, nuclear magnetic resonance, and conventional angiography did not show any venous abnormalities in the brain. CONCLUSION: During scuba diving at a depth of 20 meters, the pressure is three atmospheres, whereas within the diving mask the pressure is one atmosphere if it is not equilibrated; thus, a negative pressure is created within the mask. Small vessels can be broken in the conjunctiva or subperiosteal space by this force. It is important to exclude vascular abnormalities, especially if there is a positive family history.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
6/9. retrobulbar hemorrhage nine days after cosmetic blepharoplasty resulting in permanent visual loss.A healthy 45-year-old man had a retrobulbar hemorrhage 9 days after cosmetic upper eyelid blepharoplasty that resulted in permanent visual loss. After performing a left lateral canthotomy and cantholysis, intraocular pressure returned to normal and vision improved from no light perception to 20/40; however, the patient did have permanent visual field loss. To our knowledge, this is the longest period of time after blepharoplasty that a retrobulbar hemorrhage occurred. Ophthalmologists should have a heightened level of suspicion 1 to 2 weeks after surgery.- - - - - - - - - - ranking = 0.33333333333333keywords = pressure (Clic here for more details about this article) |
7/9. Orbital venous anomalies demonstrated by spiral computed tomography.OBJECTIVE: To describe the radiographic appearance of acute hemorrhage in orbital venous malformations and how spiral computed tomography (CT) can aid in the diagnosis of these lesions in patients with atypical presentations. DESIGN: Case series from the Eye plastics and Orbital Service of massachusetts Eye and ear Infirmary. PARTICIPANTS/INTERVENTION/MAIN OUTCOME MEASURES: Three patients who initially presented with signs and symptoms of orbital hemorrhage are presented. Their initial clinical and radiologic imaging, follow-up examination, and results of the spiral CT are summarized. RESULTS: The initial CT in each case showed a well-localized homogeneous mass in the posterior/inferior orbit. In the two cases without antecedent trauma, it was difficult to distinguish these localized hemorrhages from possible intraorbital neoplasm. On resolution of the hemorrhage, these three patients had different presentations. The first patient had intermittent proptosis that was documented by increase in exophthalmometry measurement before and after valsalva maneuver (symptomatic and with clinical signs). The second patient had a subjective orbital pressure sensation, but no visible change by examination (symptomatic but without clinical signs). The third patient was not symptomatic and had no significant clinical findings (asymptomatic and without clinical signs). Spiral CT showed the presence of an enlarging inferior orbital mass during valsalva maneuver, which was not apparent pre-Valsalva in all these patients. CONCLUSIONS: Localized hemorrhages easily may be mistaken for solid intraorbital masses: therefore, accurate determination can avoid unnecessary surgical intervention. patients with orbital venous malformation may or may not have symptoms and clinical signs of intermittent proptosis. After the resolution of the initial hemorrhage, spiral CT during valsalva maneuver using a single breath hold technique is useful in showing the presence of this venous anomaly when suspicious of this entity, even in patients who are asymptomatic.- - - - - - - - - - ranking = 0.33333333333333keywords = pressure (Clic here for more details about this article) |
8/9. Hemorrhagic ocular complications associated with the use of systemic thrombolytic agents.OBJECTIVE: This study aimed to report three patients with hemorrhagic ocular and orbital complications associated with the use of systemic thrombolytic agents. DESIGN: The study design was a retrospective small case series. PARTICIPANTS: Three eyes of three patients were studied. INTERVENTION: Surgical procedures to reduce intraocular pressure or relieve optic nerve compression were performed. MAIN OUTCOME MEASURES: visual acuity and intraocular pressure were measured. RESULTS: Three patients received an intravenous thrombolytic agent on diagnosis of an acute myocardial infarction. One patient had a spontaneous suprachoroidal hemorrhage develop with secondary acute angle closure glaucoma shortly after receiving tissue plasminogen activator. Another patient had an orbital hemorrhage develop on receiving tissue plasminogen activator 4 days after an uncomplicated cataract extraction. The third patient experienced an orbital hemorrhage while receiving streptokinase 1 day after undergoing an external levator resection. Two patients suffered significant visual loss due to glaucoma or compressive optic neuropathy. CONCLUSIONS: The onset of eye pain or visual loss after the administration of a systemic thrombolytic agent should alert the physician to the possibility of an ocular or adnexal hemorrhage. Prompt diagnosis and treatment can improve the likelihood of a favorable visual outcome.- - - - - - - - - - ranking = 0.66666666666667keywords = pressure (Clic here for more details about this article) |
9/9. Lateral canthotomy: a simple and safe procedure for orbital haemorrhage secondary to endoscopic sinus surgery.Two cases of orbital complications secondary to functional endoscopic sinus surgery are presented. One case was complicated in the immediate post-operative period with an orbital haematoma, which required urgent decompression using lateral canthotomy. The second case had presented an acute orbital haemorrhage during functional endoscopic sinus surgery, which required the same surgical procedure. These cases demonstrate that lateral canthotomy constitutes a safe and fast surgical procedure to decrease the intraorbital pressure.- - - - - - - - - - ranking = 0.33333333333333keywords = pressure (Clic here for more details about this article) |