Acute orbital compartment syndrome after lateral blow-out fracture effectively relieved by lateral cantholysis

PURPOSE: To report the observation of an acute traumatic orbital compartment syndrome in an 80-year-old man.

METHODS: Lateral canthotomy and cantholysis. Computed x-ray tomography.

RESULTS: Unilateral proptosis, blindness, a frozen globe and a dilated pupil developed within one hour after a blunt trauma to the left orbital region. Surgery two hours later resulted in normal orbital tension and near-complete recovery of functions. An orbital hematoma was found overlying a lateral blow-out fracture.

CONCLUSION: Under favorable conditions, the orbital compartment syndrome can be effectively relieved by lateral canthotomy and cantholysis. The present and previous reports suggest that two hours of orbital ischemia is near the critical time limit for recovery of full visual function.