The majority of retrobulbar hemorrhages can be managed conservatively with digital ocular massage or intravenous acetazolamide or mannitol. However, further surgical intervention is indicated when vision is at risk.
What is a retrobulbar hematoma?
Retrobulbar hematoma is a condition that involves blood congestion deep in the soft tissue of the posterior orbital septum. Although this is a rare complication, it requires considerable caution because it can cause blindness.
How is Retrobulbar hematoma diagnosed?
Signs of retrobulbar hemorrhage include proptosis, ophthalmoplegia, increased intraocular pressure, loss of pupillary reflexes, and optic disc or retinal pallor. Both Computed Tomography scan and Magnetic Resonance Imaging may be performed in the diagnosis.
How do you treat an orbital hematoma?
Decrease of vision or blindness caused by orbital hematoma may be improved through a lateral canthotomy as emergency measure and subsequently by draining the hematoma to relieve compression of the optic nerve.
What is retrobulbar injection?
Retrobulbar block is type of regional anesthetic nerve block used in intraocular surgery. In this technique, local anesthetic is injected into the retrobulbar space, the area located behind the globe of the eye.
What is lateral Canthotomy?
Lateral canthotomy, the emergency treatment for orbital compartment syndrome, is the surgical exposure of the lateral canthal tendon. Cantholysis is canthotomy plus incision of the inferior branch (crus) of the tendon.
What causes retrobulbar haemorrhage?
RBH can occur due to orbital trauma, complication of eyelid or orbital surgery, or any process that can affect blood supply to the eye, such as arteriovenous malformations, orbital varicosities, or lymphangiomas.
How do you do lateral Canthotomy and Cantholysis?
Use iris scissors to cut from the lateral canthus to the rim of the orbit, about 1 to 2 cm (canthotomy). Cut the inferior and sometimes both crus of the lateral canthal ligament (cantholysis). Most experts recommend starting with the inferior crus. Lift the lateral portion of lower eyelid.
How do you do retrobulbar?
Slowly inject 2 to 4 ml of anesthetic and remove needle. With the eye closed apply resistance to the volume injected apply pressure with gauze or (historically) a Honan balloon at 20 to 30 mmHg for 5 minutes to prevent a hemorrhage and increase diffusion of the anesthetic agent. Monitor for retrobulbar hemorrhage.
What is Peribulbar and retrobulbar?
Peribulbar anaesthesia is performed by injecting the anaesthetic drug in the orbit around the equator of the eye ball (globe). Retrobulbar anaesthesia is performed by injecting the anaesthetic drug in the orbit further back behind the eye ball, which is near the nerves that control eye movement and sensation.
What is retrobulbar hematoma (RBH)?
DOI: 10.1016/j.bjps.2017.10.025 Abstract Introduction: Retrobulbar hematoma (RBH), a rare but serious condition, can result in permanent vision loss.
Is retrobulbar hematoma associated with visual loss after endoscopic sinus surgery?
Background: Retrobulbar hematoma (RH) is a complication that can result from both otolaryngic and ophthalmologic procedures. RH can occur during endoscopic sinus surgery and improper treatment can result in several morbidities, including visual loss. Despite serious consequences, management for RH is not well evaluated.
How common is retrobulbar hemorrhage in trauma?
Orbital trauma can also lead to retrobulbar hemorrhage. Multiple studies have found an association between the use of anticoagulation medication and retrobulbar hemorrhage in trauma and postoperative patients. , Retrobulbar hemorrhage is rare. The incidence of RBH depends on the etiology of the injury.
What are the symptoms of retinal compartment hemorrhage (RBH)?
Symptoms of RBH include pain, periorbital ecchymosis, eyelid hematoma, ophthalmoplegia, proptosis, visual loss, subconjunctival hemorrhage, nausea, and vomiting. Retrobulbar hematoma, Acute angle closure glaucoma, or other etiologies of orbital compartment syndrome.
