Retrobulbar hemorrhage - Revision history

Danbot: Add MedicationDose entries for mannitol, methylprednisolone, acetazolamide

2026-03-20T21:14:37Z

Add MedicationDose entries for mannitol, methylprednisolone, acetazolamide

@@ Line 34: / Line 34: @@
 ==Disposition==
 *Admit
 ==See Also==

Rossdonaldson1: /* See Also */

2021-07-24T12:55:48Z

Rossdonaldson1: /* Background */

2021-03-17T17:45:40Z

Background

← Older revision		Revision as of 17:45, 17 March 2021
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	==Background==		==Background==
	~~[[Lateral_orbit_nerves.jpg\|thumb\|Retrobulbar space.]]~~
	*Also known as retrobulbar hematoma		*Also known as retrobulbar hematoma
	*Most often due to [[blunt orbital trauma]]		*Most often due to [[blunt orbital trauma]]

Rossdonaldson1: /* Background */

2021-03-17T17:45:07Z

Background

← Older revision		Revision as of 17:45, 17 March 2021
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	==Background==		==Background==
			[[Lateral_orbit_nerves.jpg\|thumb\|Retrobulbar space.]]
	*Also known as retrobulbar hematoma		*Also known as retrobulbar hematoma
	*Most often due to [[blunt orbital trauma]]		*Most often due to [[blunt orbital trauma]]

Rossdonaldson1: /* Evaluation */

2020-09-26T20:37:51Z

Evaluation

← Older revision		Revision as of 20:37, 26 September 2020
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	==Evaluation==		==Evaluation==
			[[File:PMC2908661 wjem-11-208f2.png\|thumb\|Computed tomography demonstrating left retrobulbar hemorrhage with proptosis.]]
	*CT Orbit		*CT Orbit
	*[[Ocular ultrasound]]<ref>Blaivas M, Theodoro D, Sierzenski PR. A study of bedside ocular ultrasonography in the emergency department. Acad Emerg Med. 2002 Aug;9(8):791-9.</ref><ref>Kilker BA, Holst JM, Hoffmann B. Bedside ocular ultrasound in the emergency department. Eur J Emerg Med. 2014 Aug;21(4):246-53.</ref><ref>Estevez A, Deutch J, Sturmann K, et al. Ultrasonography evaluation of retrobulbar hematoma in bovine orbits. Acad Emerg Med. 2000 Oct;7(10):1169-70.</ref>		*[[Ocular ultrasound]]<ref>Blaivas M, Theodoro D, Sierzenski PR. A study of bedside ocular ultrasonography in the emergency department. Acad Emerg Med. 2002 Aug;9(8):791-9.</ref><ref>Kilker BA, Holst JM, Hoffmann B. Bedside ocular ultrasound in the emergency department. Eur J Emerg Med. 2014 Aug;21(4):246-53.</ref><ref>Estevez A, Deutch J, Sturmann K, et al. Ultrasonography evaluation of retrobulbar hematoma in bovine orbits. Acad Emerg Med. 2000 Oct;7(10):1169-70.</ref>

Rossdonaldson1: /* Clinical Features */

2020-09-26T20:36:34Z

Clinical Features

← Older revision		Revision as of 20:36, 26 September 2020
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	==Clinical Features==		==Clinical Features==
			[[File:PMC3700149 NJMS-3-152-g008.png\|thumb\|Retrobulbar hemorrhage]]
	*[[Eye pain]]		*[[Eye pain]]
	*[[Proptosis]]		*[[Proptosis]]

ClaireLewis at 21:51, 6 October 2019

2019-10-06T21:51:11Z

← Older revision		Revision as of 21:51, 6 October 2019
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	==Clinical Features==		==Clinical Features==
	*[[Eye pain]]		*[[Eye pain]]
	*Proptosis		*[[Proptosis]]
	*[[Visual loss\|Decreased visual acuity]]		*[[Visual loss\|Decreased visual acuity]]
	*Elevated IOP		*Elevated [[IOP]]
	**(Do not perform tonometry if globe rupture is suspected)		**(Do not perform tonometry if globe rupture is suspected)

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	*CT Orbit		*CT Orbit
	*[[Ocular ultrasound]]<ref>Blaivas M, Theodoro D, Sierzenski PR. A study of bedside ocular ultrasonography in the emergency department. Acad Emerg Med. 2002 Aug;9(8):791-9.</ref><ref>Kilker BA, Holst JM, Hoffmann B. Bedside ocular ultrasound in the emergency department. Eur J Emerg Med. 2014 Aug;21(4):246-53.</ref><ref>Estevez A, Deutch J, Sturmann K, et al. Ultrasonography evaluation of retrobulbar hematoma in bovine orbits. Acad Emerg Med. 2000 Oct;7(10):1169-70.</ref>		*[[Ocular ultrasound]]<ref>Blaivas M, Theodoro D, Sierzenski PR. A study of bedside ocular ultrasonography in the emergency department. Acad Emerg Med. 2002 Aug;9(8):791-9.</ref><ref>Kilker BA, Holst JM, Hoffmann B. Bedside ocular ultrasound in the emergency department. Eur J Emerg Med. 2014 Aug;21(4):246-53.</ref><ref>Estevez A, Deutch J, Sturmann K, et al. Ultrasonography evaluation of retrobulbar hematoma in bovine orbits. Acad Emerg Med. 2000 Oct;7(10):1169-70.</ref>
	**Dx of retrobulbar pathology via ultrasound is technically difficult, has not been validated in the clinical setting and false-negatives have been reported<ref name="RBHTA">Thompson D, Stanescu C, Pryor P, Laselle B. Retrobulbar Hematoma from Warfarin Toxicity and the Limitations of Bedside Ocular Sonography. Western Journal of Emergency Medicine. 2010;11(2):208-210.</ref> - therefore, CT should remain the standard diagnostic tool for suspected retrobulbar pathology.		**Diagnosis of retrobulbar pathology via ultrasound is technically difficult, has not been validated in the clinical setting and false-negatives have been reported<ref name="RBHTA">Thompson D, Stanescu C, Pryor P, Laselle B. Retrobulbar Hematoma from Warfarin Toxicity and the Limitations of Bedside Ocular Sonography. Western Journal of Emergency Medicine. 2010;11(2):208-210.</ref> - therefore, CT should remain the standard diagnostic tool for suspected retrobulbar pathology.

	==Management==		==Management==

ClaireLewis at 01:26, 2 September 2019

2019-09-02T01:26:11Z

← Older revision		Revision as of 01:26, 2 September 2019
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	==Clinical Features==		==Clinical Features==
	*~~Pain~~		*[[Eye pain]]
	*Proptosis		*Proptosis
	*Decreased visual acuity		*[[Visual loss\|Decreased visual acuity]]
	*Elevated IOP		*Elevated IOP
	**(Do not perform tonometry if globe rupture is suspected)		**(Do not perform tonometry if globe rupture is suspected)
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	*Consider [[lateral canthotomy]] and cantholysis, if indicated		*Consider [[lateral canthotomy]] and cantholysis, if indicated
	*Emergent ophthalmology consultation		*Emergent ophthalmology consultation
	*Consider medical ~~mangement~~ in conjunction with cantholysis		*Consider medical management in conjunction with cantholysis
	**20% mannitol 2 g/kg IV		**20% [[mannitol]] 2 g/kg IV
	**methylprednisolone, 250mg IV or hydrocortisone 100mg IV		**[[methylprednisolone]], 250mg IV or hydrocortisone 100mg IV
	**acetazolamide, 250 to 500mg IV		**[[acetazolamide]], 250 to 500mg IV

	==Disposition==		==Disposition==

Neil.m.young: Text replacement - "==Diagnosis==" to "==Evaluation=="

2016-07-25T14:05:25Z

Text replacement - "==Diagnosis==" to "==Evaluation=="

← Older revision		Revision as of 14:05, 25 July 2016
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	{{Periorbital swelling DDX}}		{{Periorbital swelling DDX}}

	==~~Diagnosis~~==		==Evaluation==
	*CT Orbit		*CT Orbit
	*[[Ocular ultrasound]]<ref>Blaivas M, Theodoro D, Sierzenski PR. A study of bedside ocular ultrasonography in the emergency department. Acad Emerg Med. 2002 Aug;9(8):791-9.</ref><ref>Kilker BA, Holst JM, Hoffmann B. Bedside ocular ultrasound in the emergency department. Eur J Emerg Med. 2014 Aug;21(4):246-53.</ref><ref>Estevez A, Deutch J, Sturmann K, et al. Ultrasonography evaluation of retrobulbar hematoma in bovine orbits. Acad Emerg Med. 2000 Oct;7(10):1169-70.</ref>		*[[Ocular ultrasound]]<ref>Blaivas M, Theodoro D, Sierzenski PR. A study of bedside ocular ultrasonography in the emergency department. Acad Emerg Med. 2002 Aug;9(8):791-9.</ref><ref>Kilker BA, Holst JM, Hoffmann B. Bedside ocular ultrasound in the emergency department. Eur J Emerg Med. 2014 Aug;21(4):246-53.</ref><ref>Estevez A, Deutch J, Sturmann K, et al. Ultrasonography evaluation of retrobulbar hematoma in bovine orbits. Acad Emerg Med. 2000 Oct;7(10):1169-70.</ref>

Neil.m.young: Text replacement - "0 mg" to "0mg"

2016-07-21T00:59:13Z

Text replacement - "0 mg" to "0mg"

← Older revision		Revision as of 00:59, 21 July 2016
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	*Consider medical mangement in conjunction with cantholysis		*Consider medical mangement in conjunction with cantholysis
	**20% mannitol 2 g/kg IV		**20% mannitol 2 g/kg IV
	**methylprednisolone, ~~250 mg~~ IV or hydrocortisone ~~100 mg~~ IV		**methylprednisolone, 250mg IV or hydrocortisone 100mg IV
	**acetazolamide, 250 to ~~500 mg~~ IV		**acetazolamide, 250 to 500mg IV

	==Disposition==		==Disposition==

← Older revision		Revision as of 12:55, 24 July 2021
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	==See Also==		==See Also==
			*[[Ocular compartment syndrome]]
	*[[Orbital Blowout Fracture]]		*[[Orbital Blowout Fracture]]
	*[[Canthotomy]]		*[[Canthotomy]]