Retro-Orbital Hematoma

Retro-Orbital Hematoma is a topic covered in the 5-Minute Emergency Consult.

To view the entire topic, please or purchase a subscription.

Emergency Central is a collection of disease, drug, and test information including 5-Minute Emergency Medicine Consult, Davis’s Drug, McGraw-Hill Medical’s Diagnosaurus®, Pocket Guide to Diagnostic Tests, and MEDLINE Journals created for emergency medicine professionals. Explore these free sample topics:

Emergency Central

-- The first section of this topic is shown below --

Basics

Description

  • Also known as retrobulbar hematoma
  • Rare complication of orbital trauma and facial surgery
  • Collection of blood behind the globe causing increased retro-orbital pressure leading to tissue ischemia
  • Vision loss can occur within 90 min if not diagnosed and treated with irreversible damage at 120 min
  • A sight-saving procedure called lateral canthotomy is often needed to be performed in the emergency department
  • A thorough exam is needed as many patients with ROH may be unconscious
  • Frequent repeat exams are mandatory due to hematoma progression

Epidemiology

  • Incidence is difficult to estimate because ROH can be from multiple causes, both traumatic and iatrogenic.
    • 0.45–3% of blunt or penetrating trauma
    • 0.45–0.6% coexist with orbital wall fractures
    • 0.0052% of blepharoplasty
    • 0.3% of surgical facial fracture repair
    • 0.006% of endoscopic sinus surgery
  • True incidence has been debated as only slightly more than half of diagnosed retro-orbital hemorrhage has been confirmed either with a preceding CT scan or with the presence of an evacuated hematoma.

Etiology

  • Trauma to the globe or orbital walls and the orbital plexus
  • Rapid increasing pressure behind the orbit secondary to hematoma formation impedes venous outflow and arterial inflow to the retina and the optic nerve to cause orbital compartment syndrome
  • There may also be a stretching to the optic nerve as the patient develops proptosis which contributes to the decrease in visual acuity

-- To view the remaining sections of this topic, please or purchase a subscription --

Citation

* When formatting your citation, note that all book, journal, and database titles should be italicized* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Retro-Orbital Hematoma ID - 307684 Y1 - 2016 PB - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307684/all/Retro_Orbital_Hematoma ER -