opthal 2 - kallastro

[ArchivalUser]

Following blunt facial trauma, a 35-year-old patient is noted to have marked proptosis, restricted ocular movement, and decreased visual acuity of the left eye. What is the recommended temporizing maneuver?

1. Anterior chamber paracentesis
2. Carbogen inhalation
3. Globe massage
4. Lateral canthotomy
5. None of the above

[ArchivalUser]

5. (I'd probably think of steroid administration to lessen the damage)

[ArchivalUser]

4. Lateral canthotomy

[ArchivalUser]

4

[ArchivalUser]

Do u know how is it going to help, if yes please post an explanation as well ?

[ArchivalUser]

Retrobulbar hemorrhage is an ocular emergency whose prompt diagnosis and treatment are essential to prevent blindness. Because the orbit is a relatively closed compartment, orbital pressure can rise rapidly when hemorrhage occurs. Untreated, orbital compartment syndrome develops with resultant ischemia of the optic nerve.

Retrobulbar hemorrhage most often results from trauma, recent retrobulbar anesthesia, or eyelid surgery. Spontaneous retrobulbar hemorrhage due to venous anomalies, atherosclerosis, intraorbital aneurysm of the ophthalmic artery, hemophilia, leukemia, von Willebrand disease, and hypertension has also been described.

Patients with increased orbital pressure present with pain, decreased vision, diplopia, limited extraocular movements, proptosis, ecchymosis around the eye, bloody chemosis, increased intraocular pressure (IOP), resistance to retropulsion, and an afferent pupillary defect.

Orbital pressure can be relieved with an emergent lateral canthotomy. Without decompression, irreversible vision loss due to increasing orbital pressure may occur in as little as 90-120 minutes. Knowledge of this potentially sight-saving procedure is important for physicians, especially those in remote areas where access to ophthalmologists is not readily available.

[ArchivalUser]

Thanks