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Retrobulbar Haemorrhage |
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Where bleeding into the orbital space can result in compression of the optic nerve, leading to ischaemia and eventually blindness.
It can follow both trauma and surgery to the orbital region
Trauma Infra-orbital Zygomatic Le Fort Post-op Blepheroplasty Zygomatic reduction Le Fort reduction
It is essential that eye observations are carried out, post-operatively Every ¼ hr for 2 hours Every ½ hr for 2 hours 1 hourly for 4 hours 4 hourly for 24 hours
It is characterised by five signs/symptoms: ¨ PAIN (Sharp, within the globe of the eye itself) ¨ PROPTOSIS (‘bulging eye’) ¨ PUPIL REACTION to light is lost ¨ PARALYSIS (movement of the eye is restricted) ¨ VISUAL ACUITY (is reduced like a curtain falling)
‘HOT ANGRY EYE’
Treatment Immediate action Inform 2nd on call Remove any sutures in the area, for pressure relief Medication Mannitol 1g/Kg as 20% infusion Osmotic diuretic Contra-indicated in congestive heart failure and pulmonary oedema Acetazolamide 500mg IV Monitor FBC/U+E
Reduces aqueous pressure by inhibition of carbonic anhydrase (used in glaucoma) Dexamethasone 8mg po Papaverine 40mg smooth muscle relaxant Dextran 40 500mls IV improves perfusion |
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This is a very rare condition that can result in loss of vision. |
