J Emerg Med. 2019 Mar;56(3):294-297

# Ocular Compartment Syndrome and Lateral Canthotomy Procedure.

Amer E, El-Rahman Abbas A

BACKGROUND: Ocular compartment syndrome (OCS) is a serious ophthalmological emergency that should be diagnosed and treated immediately to prevent permanent loss of vision. It is usually caused by a retro-orbital bleed that will subsequently increase intra-orbital pressure and threaten the patient's vision. Lateral canthotomy and cantholysis is a minor bedside procedure using simple equipment that is readily available in emergency departments, and the aim of such a procedure is to free the eye globe from its lateral attachment to the bony orbital wall and allow more eye protrusion and hence reduce intra-orbital pressure and save the patient's sight. The case we present describes a 42-year-old man who presented with facial injuries following an alleged assault and in whom a computed tomography scan of the head showed a retro-orbital hemorrhage. The patient had subtle signs of increased intra-orbital pressure for which lateral canthotomy and cantholysis was indicated.

DISCUSSION: OCS is an ophthalmological emergency that can present with subtle signs of increased intraocular pressure that can lead to irreversible loss of vision if not treated with a simple bedside operation called lateral canthotomy and cantholysis within a specific time frame. We explore the pathophysiology and presentation of OCS and how to perform the lateral canthotomy with cantholysis procedure.

CONCLUSIONS: The aim of this case presentation is to highlight the importance of diagnosing OCS as an ophthalmological emergency and discuss how to perform the sight-saving procedure.