Posters
« Back
RETROBULBAR HEMORRHAGE IN A CHILD :  AN OPHTHALMIC EMERGENCY
EP25644
Poster Title: RETROBULBAR HEMORRHAGE IN A CHILD : AN OPHTHALMIC EMERGENCY
Submitted on 31 Mar 2017
Author(s): Dr Puspha Raman
Affiliations: Hospital Tuanku Jaafar Seremban
This poster was presented at MSO Meeting 2014
Poster Views: 2,608
View poster »


Poster Information
Abstract: a 10-year-old Malay boy, presented with left eye blurring of vision post motor vehicle accident with a windscreen injury. He has sustained multiple facial injury. He was complaining of sudden onset of blurring of vision associated with severe pain and swelling.
His visual acuity was perception of light on the leftt eye, 6/5 on the right eye. He was found to have a periorbital ecchymosis with upper and lower lid laceration wounds. He had a dense afferent pupillary defect and the ocular movements of the left eye were limited in all directions of gaze. The intraocular pressure of the right eye was 46 mmHg. The orbit was tense with significant resistance to retropulsion.
The patient was diagnosed to have an acute retrobulbar haemorrhage following blunt trauma with medial wall fracture. The haemorrhage was severe enough to compromise his optic nerve. Intravenous acetazolamide 500 mg was administered and gutt timolol 0.5% bd was commenced for the right eye. An emergency lateral canthotomy was performed.
His vision immediately improved to 6/60 and 3 hours later was 6/18 with an IOP of 26 mmHg. The child was treated for left traumatic optic neuropathy with IV Mehtylprednisolone 250mg QID for 3 days followed by two weeks of oral prednisolone
Prompt recognition and appropriate treatment of this ocular emergency is imperative, for timely management determines the ultimate outcome
Summary: Retrobulbar hemorrhage is a rare, but vision threatening condition associated with cranio-facial trauma. It can rapidly fill the orbit and cause an “orbital compartment syndrome” that subsequently cuts off perfusion to vital ocular structures. Treatment must be initiated within a limited time in order to prevent permanent visual loss. The following case highlights the emergency management of retrobulbar haemorrhage in a 10-year-old child and its clinical course.
References: 1.Burkat CN, Lemke BN. Retrobulbar hemorrhage: inferolateral anterior orbitotomy for emergent management. Arch Ophthalmol 2005;123:1260–2
2. Vassallo S, Hartstein M, Howard D, Stetz J. Traumatic retrobulbar haemorrhage emergent decompression by lateral canthotomy and cantholysis. J Emerg Med 2002;22:251–6
Report abuse »
Questions
Ask the author a question about this poster.
Ask a Question »

Creative Commons