User:Mr. Ibrahem/Lateral canthotomy
| Mr. Ibrahem/Lateral canthotomy | |
|---|---|
| File:Canthotomylateral.png Anatomy of the lateral canthus | |
| Other names | Canthotomy, lateral orbital canthotomy (LOC) |
| Specialty | Emergency medicine, ophthalmology |
| Complications | Globe injury, infection[1] |
Lateral canthotomy is an emergency procedure used to treat acute orbital compartment syndrome (OCS).[1] This may present with vision problems, increased intraocular pressure (IOP), decreased ability to move the eye, and dilation of the opposite pupil when a light is swung to shine in the affected eye.[1] Ideally it should be performed within two hours.[1] The procedure doese not take long to perform.[1]
The most common cause of acute OCS is an injury resulting in a bleeding behind the globe.[2] Other causes include spontaneous bleeding, recent eye surgery, and orbital infections.[1] Contraindications to the procedure include a ruptured globe.[1]
The procedure involves freezing the skin lateral to the eye with lidocaine with epinephrine.[1] The lateral corner of the eye is then briefly crushed with a hemostat.[1] A 1 to 2 cm cut is then made through this tissue with blunt tipped scissors.[1] The lower eyelid is then pulled away to expose the lateral canthal tendon.[1] The lower part of this tendon is than cut with the scissors.[1] If this is not sufficient the upper part may also be cut.[1]
Signs of success include a mobile lower eyelid, decreased IOP, and improved vision.[1] After the procedure the cut is left open and covered with a sterile dressing.[2] The head of the bed should be placed at 45 degrees, if possible.[3] Closure may occur by an ophthalmologist after a few days.[1]
References[edit]
- ^ a b c d e f g h i j k l m n o p q r Desai, NM; Shah, Su (January 2021). "Lateral Orbital Canthotomy". PMID 32491408.
{{cite journal}}: Cite journal requires|journal=(help) - ^ a b c Ballard, SR; Enzenauer, RW; O'Donnell, T; Fleming, JC; Risk, G; Waite, AN (2009). "Emergency lateral canthotomy and cantholysis: a simple procedure to preserve vision from sight threatening orbital hemorrhage". Journal of special operations medicine : a peer reviewed journal for SOF medical professionals. 9 (3): 26–32. PMID 19739474.
- ^ "Orbital Compartment Syndrome" (PDF). MAGPAS AIr Ambulance. June 2018. Retrieved 14 March 2021.