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Orbital Compartment Syndrome

 


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 enlarging ...

DIAGNOSIS

Mostly made on a clinical basis 

HISTORY

Key symptom: progressive visual impairment in setting of increased intraorbital pressure. Also ask about the following: 
  • Acute onset of pain

  • Painful peri...

TREATMENT

ALERT

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

ADDITIONAL READING

  • Johnson D, Winterborn A, Kratky V. Efficacy of intravenous mannitol in the management of orbital compartment syndrome: a nonhuman primate model. Ophthal Plast Reconstr Surg.  2...

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 sometimes labs and imaging may be useful in determining severity and for risk stratification.

  • OCS is an ophthalmologic emergency, requiri...

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