Traumatic eye injuries ranging from mild corneal abrasions to penetrating globe injuries are commonly seen in the ED, and ocular trauma accounts for nearly 1% of all complaints in the ED.1 Up to 29% of facial fractures have associated eye injuries.2 Emergency physicians (EPs) must be aware of possible eye injuries, including traumatic vision loss, and the indicators for emergent interventions.
Tension pneumo-orbitum following facial trauma is rarely reported. We present a case of orbital compartment syndrome (OCS) in an elderly woman who sustained an orbital floor fracture and required emergent lateral canthotomy to preserve vision.
Case
A 76-year-old woman presented to the ED for evaluation of pain, swelling, and loss of vision in the right eye. She said she had been sitting in a chair tying her shoes when she lost her balance and fell forward, striking her head and the right side of her face against the floor. She experienced no loss of consciousness and denied any neck pain, jaw pain, or dizziness. She also denied any chest pain, shortness of breath, weakness, or loss of function in either her arms or legs. She did, however, note a small nosebleed that had stopped before she arrived at the ED. The patient’s primary complaint was a possible nasal bone fracture.
