Retrobulbar hemorrhage: Difference between revisions
No edit summary |
No edit summary |
||
| Line 9: | Line 9: | ||
*Proptosis | *Proptosis | ||
*Decreased visual acuity | *Decreased visual acuity | ||
*Elevated IOP | *Elevated IOP | ||
**(Do not perform tonometry if globe rupture is suspected) | |||
==Diagnosis== | ==Diagnosis== | ||
*CT Orbit | *CT Orbit | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
| Line 23: | Line 22: | ||
==Treatment== | ==Treatment== | ||
*Emergent ophthalmology consultation | *Emergent ophthalmology consultation | ||
*Consider | *Consider [[lateral canthotomy]] and cantholysis, if indicated | ||
==Disposition== | ==Disposition== | ||
Revision as of 21:16, 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
- (Do not perform tonometry if globe rupture is suspected)
Diagnosis
- CT Orbit
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