ABSTRACT
Expanding orbital haematoma (or retrobulbar haemorrhage) is a rare, potentially sight-threatening complication which results from trauma to one of the orbital arteries – namely, the branches of the ophthalmic artery (anterior and posterior ethmoidal arteries) or orbital vein. Such an orbital injury can result from head trauma or can be iatrogenic. Very rarely, it can occur spontaneously. As the haematoma expands within the confines of the bony orbit, the tense sheet of tissue that stretches across the anterior orbital opening – the orbital septum – prevents the escape of blood. Retrobulbar haemorrhage (RBH) can occur as a result of trauma, eyelid or orbital surgery, and other processes affecting the circulation within the orbit, such as arteriovenous malformations and lymphangiomas. The use of anticoagulant medication can increase the risk of RBH after relatively minor head trauma. Signs of a retrobulbar haemorrhage include periorbital swelling, bruising and oedema, conjunctival chemosis and subconjunctival haemorrhage.
