Acute Orbital Compartment Syndrome Clinical Presentation

Updated: Jun 06, 2019
  • Author: Bryant C Shannon, MD; Chief Editor: Gregory Sugalski, MD  more...
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Symptoms of acute orbital compartment syndrome may include the following:

  • Eye pain
  • Diplopia
  • Visual loss
  • Reduction of ocular motility
  • Proptosis

Physical Examination

Physical examination should not be delayed in patients with acute trauma, as progressive periorbital swelling can obscure the examination. Examination is typically conducted in an external to internal progression, as follows: [13]

  • Proptosis (best visualized in perpendicular plane with the patient in semi-reclining position)
  • Ecchymosis of eyelid
  • Chemosis
  • Tactile firmness/tense orbit (helpful in unconscious patients)
  • Intraocular pressure
  • Visual acuity
  • Ophthalmoplegia
  • Afferent pupillary defect
  • Red light reflex
  • Fluorescein stain (useful for Seidel sign if rupture is a concern)
  • Papilledema
  • Central retinal artery pulsation
  • Pale optic disc (late)
  • Cherry-red macula (rare)