Orbital Compartment Syndrome

Jordan I. Teitelbaum, DO Reviewed 06/2022

BASICS

DESCRIPTION

Sight-threatening emergency characterized by elevated intraorbital pressure, compromising blood flow to the optic nerve and globe and causing visual loss (1)^. With subacute and acut...

DIAGNOSIS

Made on a clinical basis from history, exam, and orbital imaging

HISTORY

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

Acu...

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

Lima V, Burt B, Leibovitch I, et al. Orbital compartment syndrome: the ophthalmic surgical emergency. Surv Ophthalmol. 2009;54(4):441–449. [View Abstract o...

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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