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Retrobulbar haemorrhage — ACEM Fellowship MCQ

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ModerateTraumaRetrobulbar haemorrhageACEM Fellowship

A 30-year-old man presents to an Adelaide ED, triage category 2, after being punched in the eye. Visual acuity is hand movements, intraocular pressure is 48 mmHg, the globe is proptosed and the pupil is sluggish. CT is delayed by another resuscitation. What is the most important immediate action?

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Reveal the answer and explanation

Correct answer: B — Perform lateral canthotomy and cantholysis

Proptosis, high intraocular pressure and visual loss after trauma indicate orbital compartment syndrome requiring immediate canthotomy.

Reference: ACEM ophthalmic trauma curriculum; emergency ophthalmology guidance