Universität zu Köln

Kopecky, Adam ORCID: 0000-0002-1782-0617, Rokohl, Alexander Christopher ORCID: 0000-0002-0224-3597, Nemcansky, Jan ORCID: 0000-0003-1979-6419, Koch, Konrad R., Matousek, Petr ORCID: 0000-0002-0930-6773 and Heindl, Ludwig M. (2021). Retrobulbar Haematoma - a Complication that May Impair Vision. Klinische Monatsblat. Augenheilkunde, 238 (5). S. 609 - 616. STUTTGART: GEORG THIEME VERLAG KG. ISSN 1439-3999

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Abstract

Retrobulbar haematoma (RBH) is a rare complication that may affect vision after a trauma or a surgical procedure. The diagnosis must be made promptly, as only early surgical intervention can adequately prevent irreversible visual impairment. Because of the bony orbital walls, there is hardly any room for the increasing intraorbital volume due to the retrobulbar haemorrhage. This leads to an increase in intraorbital pressure and subsequently to compression of the optic nerve. Symptoms include disorders in ocular motility, ophthalmoplegia, diplopia, conjunctival chemosis, subconjunctival haemorrhage, proptosis, increased intraocular pressure, deterioration in visual acuity, decreased direct pupillary reflex, and a relative afferent pupillary defect. If the cause is traumatic or iatrogenic, prompt lateral canthotomy with cantholysis is the treatment of choice, and successfully lowers pressure in most cases. It can be performed in the emergency room by an ophthalmologist and may even be indicated without previous imaging. As the reconstruction of cantholysis is generally uncomplicated, we recommend performing the procedure when RBH is suspected. If canthotomy with cantholysis does not lead to adequate improvement, surgical orbital decompression must be performed. Supportive treatment should always include systemic steroids.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Kopecky, Adam UNSPECIFIED orcid.org/0000-0002-1782-0617 UNSPECIFIED Rokohl, Alexander Christopher UNSPECIFIED orcid.org/0000-0002-0224-3597 UNSPECIFIED Nemcansky, Jan UNSPECIFIED orcid.org/0000-0003-1979-6419 UNSPECIFIED Koch, Konrad R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Matousek, Petr UNSPECIFIED orcid.org/0000-0002-0930-6773 UNSPECIFIED Heindl, Ludwig M. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-585139
DOI:	10.1055/a-0958-9584
Journal or Publication Title:	Klinische Monatsblat. Augenheilkunde
Volume:	238
Number:	5
Page Range:	S. 609 - 616
Date:	2021
Publisher:	GEORG THIEME VERLAG KG
Place of Publication:	STUTTGART
ISSN:	1439-3999
Language:	German
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language VISUAL-LOSS; HEMORRHAGE; MANAGEMENT; ANESTHESIA; INJECTION Multiple languages Ophthalmology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/58513