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One of the uncommon but severe
endoscopic sinus surgery
Orbital Compartment Syndrome. This can be caused by blood or rarely air
which enters behind the eye. As pressure increases permanent blindness may
occur. An orbital
hematomais caused when blood enters behind the orbit
and slowly expands. During surgery injury may occur to the bone lining the
eye or blood vessels may be injured and retract into the orbit. As the
pressure builds, the eyelids swell and the eye bulges outward (proptosis) and
the vision fades. If treatment is not carried out immediately blindness
Treatment May Includes:
Nasal Packs are pulled and the globe is
intermittently massage to try to slow the bleeding.
Manitol is given IV 1 to 2 grams per kilogram
over 20-30 minutes
The lateral portion of the lower lid may be
canthotomy) to relieve pressure.
bone between the
and the orbit (the bony cavity which houses the
eye) is paper thin and is called the lamina papyracea (layer of paper).
During surgery, this layer may become cracked. Forceful sneezing or
blowing of the nose may cause air to enter the orbit causing proptosis and
rarely blindness. This is a self limiting disorder which will resolve on
its own as the air is absorbed by the body. However, if severe then the
patent should be treated with orbital massage, manitol and, if loss of vision is
canthotomy. The patient should be instructed not to
blow his/her nose and if the patient has to sneeze to sneeze with his/her mouth