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Retrobulbar hematoma — ABEM Board MCQ

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HardTraumaRetrobulbar hematomaABEM Board

A 37-year-old man arrives after being struck in the orbit by a baseball. Triage acuity is ESI 2; BP 142/80 mm Hg, HR 94/min. He has severe eye pain, proptosis, decreased vision, relative afferent pupillary defect, and intraocular pressure of 48 mm Hg. Which of the following is the most important immediate intervention?

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Correct answer: C — Perform lateral canthotomy and cantholysis

Orbital compartment syndrome with vision compromise requires immediate lateral canthotomy and cantholysis without waiting for imaging.

Reference: AAO orbital compartment guidance; emergency ophthalmology references