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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

1
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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