Episode 51 - Eye Trauma

Emergency medicine providers must master critical eye procedures and trauma assessment to prevent irreversible vision loss. Orbital compartment syndrome requires immediate lateral canthotomy and cantholysis, specifically cutting the inferior crus of the lateral canthal ligament to reduce intraocular pressure, ideally targeting a threshold of 40 mmHg. When evaluating orbital trauma, clinicians must prioritize ruling out globe rupture—indicated by signs like Seidel’s sign or hemorrhagic chemosis—before performing tonometry. Management of hyphema focuses on minimizing re-bleeding through head elevation and potential pharmacological intervention, while chemical eye burns necessitate aggressive irrigation until the ocular pH normalizes. Proper documentation of visual acuity, pupils, and intraocular pressure remains essential for effective ophthalmological consultation, ensuring that life- and organ-saving interventions are executed promptly in the emergency department.