Clinical Experience of Retrobulbar Hematoma in Closed Reduction of Zygoma Fracture.

Lee, Ki Ho; Kim, Hyung Soo; Kang, Nak Heon

Case Report

Journal of Korean Cleft Palate-Craniofacial Association 2004;5(1):55-57.

Department of Plastic & Reconstructive Surgery, College of Medicine, Chungnam National University, Daejeon, Korea. plasu3769@han mail.net

Abstract

Retrobulbar hematoma is a rare condition caused by direct trauma and postopertive complication. But, if prompt treatments delayed, retobular hematoma can cause catastrophic loss of vision. Proposed mechanism of visual loss by retrobulbar hematoma are increased intraocular pressure, retinal ischemia secondary to central artery occlusion, optic nerve compression and resultant ischemia. When retobulbar hematoma is suspected, medical and surgical treatment are needed. Which includes intravenous osmotic agents, acetazolamide, and beta-blocker eyedrops and prompt surgical exploration, such as lateral canthotomy. We report a case of retrobular hematoma occurred in closed reduction on zygoma fracture of 56-years-old female. In operation, abrrupt mydriasis, exophthalmos, and chemosis are detected and eyeball movement restriction observed. so we consulted these situation to ophthalmologist. He examined the patient and diagnosed as retrobulbar hematoma. So we ceased operation and incised lateral canthotomy promptly and solumedrol 500mg, 15% mannitol 500ml injected intravenously. Postoperative 2 days later, periorbital swelling and chemosis still remained, but mydriasis and eyeball movement restriction are disappeared.

Keywords: Retrobulbar hematoma