Orbital compartment syndrome

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Orbital compartment syndrome
Retrobulbar bleeding resulting in orbital compartment syndrome[1]
SpecialtyEmergency medicine, ophthalmology
SymptomsDecreased vision, bulging of the eye, double vision, pain, firm eye[2]
CausesRetrobulbar bleeding, infection, cancer, burns, air[2][4]
Diagnostic methodBased on symptoms, supported by medical imaging[4]
TreatmentLateral canthotomy[3]

Orbital compartment syndrome (OCS) is the result of rapid increase in pressure within the orbit.[3] Symptoms may include decreased vision, bulging of the eye, double vision, and pain.[2] The eye is typical firm to touch with a dilated non reactive pupil.[2][4] Without treatment complications can include blindness.[3]

Relatively common causes include retrobulbar bleeding due to either injury or eye surgery.[2] Other causes include infection, cancer, burns, and air behind the eye.[2][4] Diagnosis is based on symptoms, though may be supported by medical imaging in unclear cases.[4][2]

Treatment is by lateral canthotomy.[3] This should be performed as soon as the diagnosis is suspected when vision problems are present.[2] While it is generally best for this to be performed rapidly after the onset of the condition, cases of vision recovery in delayed cases have been reported.[2]

Orbital compartment syndrome is rare.[2][5] It was first diagnosed in 1950 by Gordon and McRae.[3]


  1. Ballard, SR; Enzenauer, RW; O'Donnell, T; Fleming, JC; Risk, G; Waite, AN (2009). "Emergency lateral canthotomy and cantholysis: a simple procedure to preserve vision from sight threatening orbital hemorrhage". Journal of special operations medicine : a peer reviewed journal for SOF medical professionals. 9 (3): 26–32. PMID 19739474.
  2. 2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 2.9 McCallum, E; Keren, S; Lapira, M; Norris, JH (2019). "Orbital Compartment Syndrome: An Update With Review Of The Literature". Clinical ophthalmology (Auckland, N.Z.). 13: 2189–2194. doi:10.2147/OPTH.S180058. PMID 31806931.
  3. 3.0 3.1 3.2 3.3 3.4 3.5 Desai, NM; Shah, Su (January 2021). "Lateral Orbital Canthotomy". PMID 32491408. {{cite journal}}: Cite journal requires |journal= (help)
  4. 4.0 4.1 4.2 4.3 4.4 Smith, Hamish. "Orbital compartment syndrome | Radiology Reference Article | Radiopaedia.org". Radiopaedia. Archived from the original on 22 October 2020. Retrieved 26 March 2021.
  5. 5.0 5.1 "Orbital Compartment Syndrome: Pearls and Pitfalls for the ED Physician". REBEL EM - Emergency Medicine Blog. 26 October 2020. Archived from the original on 28 February 2021. Retrieved 26 March 2021.