ABSTRACT
This chapter presents a case study of a 29-year-old male who is brought to the Emergency Department after an alleged assault with a table leg. He reports increasing pain and deterioration in vision in the left eye. This is associated with a mild headache, but he denies any nausea, vomiting or blackouts. He has a history of asthma managed with inhaled salbutamol. He has no past ophthalmic history. The case highlights the cardinal signs of ocular compartment syndrome caused by retrobulbar haemorrhage – proptosis, restriction of eye movement, RAPD, reduced visual acuity, colour vision and worsening pain. Delay in recognition and treatment can result in permanent visual loss. Lateral cantholysis (canthotomy) is an emergency measure that can relieve compartment syndrome and buy time for definitive treatment. There is low risk of morbidity associated with the procedure, so if in doubt, it is better to perform the procedure than risk preventable visual loss.
