1/23. Lateral canthotomy and inferior cantholysis: an effective method of urgent orbital decompression for sight threatening acute retrobulbar haemorrhage.Retrobulbar haemorrhage (RBH) occurs in a variety of situations. It can complicate facial fractures, orbital surgery and retrobulbar injections and can occur spontaneously. It is relatively uncommon and sight-threatening RBH is even less common. If not detected early enough it can lead to devastating loss of vision. We have collected five cases of acute RBH, following trauma, associated with a profound reduction in vision. In each case a permanent loss of vision was avoided using a lateral canthotomy and inferior cantholysis approach to obtain urgent orbital decompression.- - - - - - - - - - ranking = 1keywords = retrobulbar (Clic here for more details about this article) |
2/23. Traumatic intramuscular orbital haemorrhage.Retrobulbar haemorrhage is an uncommon but well-documented complication of retrobulbar anaesthetic blocks in ocular surgery. Peribulbar anaesthesia has been advocated to be equally effective but safer. The incidence of retrobulbar haemorrhage with peribulbar blocks is very low. We report a case in which a peribulbar anaesthetic for cataract surgery resulted in sight-threatening retrobulbar haemorrhage within the medial rectus muscle and required an anterior orbitotomy and direct decompression of the muscle. The surgery was successful. This case illustrates a potentially serious complication of peribulbar anaesthesia, with the successful outcome achieved by rapid definitive diagnosis and intervention.- - - - - - - - - - ranking = 0.6keywords = retrobulbar (Clic here for more details about this article) |
3/23. 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 = 8.0733129329778E-6keywords = optic (Clic here for more details about this article) |
4/23. Delayed retrobulbar hematoma after blepharoplasty.PURPOSE: To describe a case of late orbital hematoma after blepharoplasty and review the literature on this subject. methods: A healthy woman developed an orbital hematoma and loss of vision 7 days after an elective blepharoplasty. Computed tomography and magnetic resonance images of the orbits were obtained 1 day after the vascular accident. RESULTS: Computed tomography and magnetic resonance images clearly demonstrated that the site of the hemorrhage was the superior nasal fat pad. blood from this region molded the globe and accumulated in the intraconal space behind the posterior sclera. The patient was successfully treated with conservative measures only. CONCLUSIONS: Orbital hematoma, which is the main cause of loss of vision after blepharoplasty, can be a late postoperative complication.- - - - - - - - - - ranking = 0.8keywords = retrobulbar (Clic here for more details about this article) |
5/23. Bilateral orbital hemorrhage induced by labor.We describe a woman in whom bilateral orbital hemorrhage occurred during labor. She developed sudden proptosis and complete loss of vision bilaterally. After a stillbirth, she underwent total hysterectomy because of atonic uterus and postpartum hemorrhage. The location of the hematomas was confirmed by magnetic resonance imaging. Clinical resolution occurred in one month but both eyes remained blind. Fundoscopy revealed bilateral atrophy of the optic discs.- - - - - - - - - - ranking = 8.0733129329778E-6keywords = optic (Clic here for more details about this article) |
6/23. Delayed orbital hemorrhage after cataract surgery in a patient with an acquired factor viii inhibitor.PURPOSE: To report the occurrence of delayed orbital hemorrhage after cataract surgery with retrobulbar anesthesia in a patient with previously unknown acquired factor viii antibodies. methods: Interventional case report. A 79-year-old woman underwent uneventful cataract surgery with retrobulbar anesthesia and subsequently incurred a severe orbital hemorrhage 12 hours postoperatively. RESULTS: Despite aggressive surgical and medical intervention, the patient lost all vision in the involved eye. CONCLUSION: Delayed postoperative retrobulbar hemorrhage may cause total loss of vision in patients with acquired factor viii antibodies.- - - - - - - - - - ranking = 0.6keywords = retrobulbar (Clic here for more details about this article) |
7/23. Spontaneous retrobulbar hemorrhage in type IV ehlers-danlos syndrome.PURPOSE: To describe a case of spontaneous retrobulbar hemorrhage in type IV ehlers-danlos syndrome, a disorder characterized by vascular fragility and associated severe bleeding problems. methods: Observational case report. Spontaneous unilateral retrobulbar hemorrhage in a 22-year-old man with type IV ehlers-danlos syndrome was documented by clinical and radiographic examination. RESULTS: The retrobulbar hemorrhage was self-limited and resolved without visual sequelae. CONCLUSION: Spontaneous retrobulbar hemorrhage should be recognized as part of the spectrum of type IV ehlers-danlos syndrome, and clinicians must be alert to diagnosis and treatment of this vision-threatening problem.- - - - - - - - - - ranking = 1.6keywords = retrobulbar (Clic here for more details about this article) |
8/23. Subperiosteal orbital hemorrhage as initial manifestation of Christmas disease (factor ix deficiency).PURPOSE: To report a case of subperiosteal orbital and subgaleal hemorrhage with optic nerve compromise in a patient with a factor ix deficiency. DESIGN: Interventional case report. methods: A 5-year-old male presented 10 days after mild trauma with progressive left-sided scalp swelling, proptosis, and visual loss. RESULTS: The patient had marked proptosis of the left eye, 20/200 visual acuity, and an afferent pupillary defect. magnetic resonance imaging demonstrated a large subgaleal and left subperiosteal orbital hematoma. Quantitative assays of coagulation proteins identified a factor ix deficiency (Christmas disease). CONCLUSION: Delayed-onset subgaleal and subperiosteal orbital hematoma can rarely be an initial manifestation of Christmas disease.- - - - - - - - - - ranking = 8.0733129329778E-6keywords = optic (Clic here for more details about this article) |
9/23. Traumatic retrobulbar hemorrhage: emergent decompression by lateral canthotomy and cantholysis.Traumatic retrobulbar hemorrhage may result in acute loss of vision that is reversible when recognized and treated promptly. A case of traumatic retrobulbar hemorrhage is presented. The technique of emergent orbital decompression by lateral canthotomy and cantholysis is described. The anatomy of the lateral canthus and the surgical procedure are illustrated by gross dissection.- - - - - - - - - - ranking = 1.2keywords = retrobulbar (Clic here for more details about this article) |
10/23. Attempted bilateral manual enucleation (gouging) during a physical assault.OBJECTIVE: To report a rare, severe case of partial traumatic bilateral enucleation and its assessment and management. DESIGN: Case report and literature review. methods: A report of clinical and imaging findings, surgical procedure, medical treatment, and final outcome. RESULTS: Complete avulsion of the extraocular muscles and optic nerve resulted in total loss of vision in one eye. Partial visual recovery was achieved by operating on the fellow eye, which was partially avulsed. Both eyes underwent lateral canthotomy in the emergency room. This was followed by exploration, repair of all ruptured extraocular muscles, and anterior chamber tap under general anesthesia. The few previously reported cases of traumatic manual avulsion of the globe are reviewed and discussed in the context of the present case. CONCLUSIONS: Partial visual recovery can be achieved after severe orbital and optic nerve trauma. A multidisciplinary approach to the assessment and management of these patients is recommended.- - - - - - - - - - ranking = 1.6146625865956E-5keywords = optic (Clic here for more details about this article) |
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