(BMJ)—An elderly woman on warfarin presented w/ eye pain and loss of vision 1 day after left eye surgery. Exam: periorbital ecchymoses, chemosis, proptosis. VA: light perception only. What is the initial definitive tx for her condition?
Ophthalmic laser surgery
Acetazolamide/ophthalmic beta blockers
Lateral canthotomy
Infusion of fresh frozen plasma
Retinal artery embolization
You are correct. Immediate decompression w/ lateral canthotomy is 1st-line tx for retrobulbar hemorrhage, a vision-threatening emergency. Retrobulbar hemorrhage typically occurs secondary to facial trauma or a surgical procedure. Without prompt recognition and tx, the hemorrhage can expand and produce an orbital compartment syndrome leading to high intraocular pressure, optic nerve damage, and retinal ischemia due to compromised vascular flow. Permanent vision loss can occur w/in 1 to 2 h of total vascular insufficiency. Acetazolamide and ophthalmic beta blockers may be used as adjuncts to decompression.
By vgreene, 22 January, 2015
By vgreene, 22 January, 2015
By vgreene, 22 January, 2015
By vgreene, 22 January, 2015