Orbital Compartment Syndrome

Jordan I. Teitelbaum, FARS, DO Reviewed 04/2024

BASICS

Orbital compartment syndrome (OCS) is a vision-threatening emergency caused by elevated intraorbital pressure which exceeds the vascular perfusion pressure of the ophthalmic artery. It can resu...

DIAGNOSIS

Made on a clinical basis

HISTORY

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

Acute onset of pain
Painful periorbital edem...

TREATMENT

ALERT

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

GENERAL MEASURES

Avoid blowing the nose, Valsalva maneuver, or coughing.
Elevate th...

ONGOING CARE

PATIENT EDUCATION

Immediately seek medical assistance if they have increased pain, proptosis, double vision, or blurry vision, which may signal worsening of disease or disease recurrence.

PROGNOSIS

REFERENCES

McCallum E, Keren S, Lapira M, et al. Orbital Compartment Syndrome: An Update With Review Of The Literature. Clin Ophthalmol. 2019;13:2189–2194. doi:

10.2147/OPTH.S180058. PMID: 31806931.

...

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 an ophthalmologic emergency requiring immediate surgical treatment as delayed treatment may result in permanent blindness.
OCS is primarily a clinical diagnosis, although lab wor...

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