Podcast 504: Ocular Compartment Syndrome

Contributor: Don Stader, MD

Educational Pearls:

• The eye is surrounded by relatively inflexible tissues such as the bone of the orbit and the fibrous tissue of the eye. This makes it relatively susceptible to damage from outside compression, which is most common from trauma. This phenomenon is called ocular compartment syndrome (OCS) 
• Look for OCS when patients have face, head or direct eye trauma 
• OCS will present with a swollen, bulging eye associated with pain and blurry vision. Typically diagnosed with an elevated intraocular pressure (>40)
• OCS needs to be treated with a lateral canthotomy to help expand the area around the eye, reducing the pressure.
• Can’t see the eye due to swelling? Use paper clips to make eyelid retractors!

References

Lima V, Burt B, Leibovitch I, Prabhakaran V, Goldberg RA, Selva D. Orbital compartment syndrome: the ophthalmic surgical emergency. Surv Ophthalmol. 2009 Jul-Aug;54(4):441-9. doi: 10.1016/j.survophthal.2009.04.005. Review. PubMed PMID: 19539832.

Rowh AD, Ufberg JW, Chan TC, Vilke GM, Harrigan RA. Lateral canthotomy and cantholysis: emergency management of orbital compartment syndrome. J Emerg Med. 2015 Mar;48(3):325-30. doi: 10.1016/j.jemermed.2014.11.002. Epub 2014 Dec 16. PubMed PMID: 25524455.

Summarized by Will Dewispelaere, MS4 | Edited by Erik Verzemnieks, MD