VizD Vol 1.5

Case 1.5

A 53-year-old woman presents to your ED after tripping down a flight of steps. On exam, you note marked swelling of her right orbit with proptosis of the right eye. You ask the patient to look to the side but she cannot move her eye.

1. What is the procedure being performed?
2. What is the most common reason to perform the procedure?
3. What complication are you trying to prevent in performing this procedure?

Please post your answer in the “reply box” or click on the “comments” link  You will not see your answer post until next week when all of the submitted answers will be posted.  Good luck!

VizD is a weekly contest of an interesting or pathognomonic image from emergency medicine. Its goal is to integrate learning into a fun and relaxed environment. All images are original and are posted with the consent of the patient.

9 Responses

  1. The procedure is a lateral canthotomy. The emergent indication is retrobulbar hemorrage.
    Complications of an untreated hemorrage include orbital compartment syndrome which leads to ischemia of the optic nerve and irreversible blindness.

  2. 1. Lateral Canthotomy
    2. Retrobulbar Hematoma resulting in orbital compartment syndrome
    3. Permanent vision loss due to elevated IOP resulting in ischemia to the retinal artery, optic nerve and its vascular supply.

  3. 1) lateral canthotomy

    2) Retrobulbar hemorrhage

    3) irreversible vision loss secondary to retinal ischemia

  4. 1) Lateral canthotomy
    2) Increase in intraocular pressure secondary to retrobulbar hemorrhage. You can also get a loss of visual acuity, proptosis, or loss of intraocular movements.
    3) You are trying to prevent any injury to the globe.

  5. 1. Lateral Canthotomy
    2. Retrobulbar Hematoma
    3. Procedure is to prevent the complication of Blindness. Other complications include: iatrogenic globe injury, bleeding, and infection

  6. 1) Lateral Canthotomy
    2) Retrobulbar hemorrhage with visual loss and increased IOP
    3) Orbital compartment syndrome with resultant ischemia of the optic nerve

  7. 1-lateral canthotomy
    2-retrobulbar hemorrhage
    3-blindness…(or do you mean what complication are you trying to avoid while performing the procedure? in that case I think globe rupture)

  8. 1. Lateral Canthotomy
    2. Retrobulbar Hematoma
    3. Blindness/Visual loss secondary to strain on the optic nerve

  9. 1. lateral canthotomy
    2. retrobulbar hemorrhage
    3. compromise of retinal circulation (central retinal artery occlusion)

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