Retrobulbar hemorrhage: Difference between revisions
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==Background== | ==Background== | ||
*Also known as retrobulbar hematoma | |||
*Most often due to [[blunt orbital trauma]] | *Most often due to [[blunt orbital trauma]] | ||
*Can cause loss of vision due to abrupt increase in intraocular pressure | **Can also be 2/2 spontaneous bleeding | ||
*Can cause loss of vision due to abrupt increase in intraocular pressure → orbital compartment syndrome (OCS) | |||
==Clinical Features== | ==Clinical Features== | ||
*Pain | |||
*Proptosis | |||
*Decreased visual acuity | |||
*Elevated IOP | |||
==Diagnosis== | ==Diagnosis== | ||
*CT Orbit | |||
*Tonometry | |||
**Only measure once globe rupture has been ruled-out | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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==Treatment== | ==Treatment== | ||
*Emergent ophthalmology consultation | |||
*Consider lateral [[canthotomy]] and cantholysis, if indicated | |||
==Disposition== | |||
*Admit | |||
==See Also== | ==See Also== | ||
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*[[Blunt Eye Trauma]] | *[[Blunt Eye Trauma]] | ||
== | ==References== | ||
<references/> | |||
[[Category:Ophtho]] | [[Category:Ophtho]] | ||
Revision as of 05:09, 3 July 2015
Background
- Also known as retrobulbar hematoma
- Most often due to blunt orbital trauma
- Can also be 2/2 spontaneous bleeding
- Can cause loss of vision due to abrupt increase in intraocular pressure → orbital compartment syndrome (OCS)
Clinical Features
- Pain
- Proptosis
- Decreased visual acuity
- Elevated IOP
Diagnosis
- CT Orbit
- Tonometry
- Only measure once globe rupture has been ruled-out
Differential Diagnosis
Maxillofacial Trauma
- Ears
- Nose
- Oral
- Other face
- Zygomatic arch fracture
- Zygomaticomaxillary (tripod) fracture
- Related
Periorbital swelling
Proptosis
- Normal IOP
- Orbital cellulitis
- Orbital pseudotumor
- Orbital tumor
- Increased IOP
- Retrobulbar abscess
- Retrobulbar emphysema
- Retrobulbar hemorrhage
- Ocular compartment syndrome
- Orbital tumor
No proptosis
- Periorbital cellulitis/erysipelas
- Dacryocystitis (lacrimal duct)
- Dacryocele/Dacryocystocele
- Dacryostenosis
- Dacryoadenitis (lacrimal gland)
- Allergic reaction
- Nephrotic Syndrome (pediatrics)
Lid Complications
- Blepharitis (crusts)
- Chalazion (meibomian gland)
- Stye (hordeolum) (eyelash folicle)
Other
- Subperiosteal abscess
- Orbital abscess
- Cavernous sinus thrombosis
- Conjunctivitis
- Contact dermatitis
- Herpes zoster
- Herpes simplex
- Sarcoidosis
- Granulomatosis with polyangiitis
Treatment
- Emergent ophthalmology consultation
- Consider lateral canthotomy and cantholysis, if indicated
Disposition
- Admit