Orbital Compartment Syndrome

Jordan I. Teitelbaum, DO and Christopher R. Selinsky, DO Reviewed 06/2019

BASICS

DESCRIPTION

Elevated intraorbital pressure, compromising blood flow to the optic nerve and globe
Subacute versus acute subtypes
- Subacute orbital compartment syndrome (OCS) may be due to enlargin...

DIAGNOSIS

Mostly made on a clinical basis from history and exam

HISTORY

Key symptom: progressive visual impairment in setting of increased intraorbital pressure. Patient may also report:

Acute onset of...

TREATMENT

ALERT

In acute OCS, immediate lateral canthotomy and cantholysis are required to prevent impending blindness.

GENERAL MEASURES

Patients should avoid blowing the nose, Valsalva maneuver, or cou...

ONGOING CARE

PATIENT EDUCATION

Patients should immediately seek medical assistance if they have increased pain, proptosis, double vision, or blurry vision, which may signal worsening of disease or dise...

REFERENCES

Ahnood D, Toft PB. Recurrent orbital compartment syndrome caused by a blow-out fracture and accumulation of air: management by orbital punctures. Acta Ophthalmol. 2012;90(2):199–200....

ADDITIONAL READING

Johnson D, Winterborn A, Kratky V. Efficacy of intravenous mannitol in the management of orbital compartment syndrome: a nonhuman primate model. Ophthalmic Plast Reconstr Surg. ...

CODES

ICD10

H40.059 Ocular hypertension, unspecified eye
H05.20 Unspecified exophthalmos
H05.239 Hemorrhage of unspecified orbit
H05.269 Pulsating exophthalmos, unspecified eye
H40.052 Ocular hypertension,...

CLINICAL PEARLS

OCS is primarily a clinical diagnosis, although lab work and imaging may be useful in determining severity, risk stratification, and operative planning.
OCS is an ophthalmologic emergen...

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