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Orbital hemorrhage during dacryocystorhinostomy.
J J Hurwitz1, C J Eplett, D Fliss
1Department of Ophthalmology, University of Toronto, Mount Sinai Hospital, On.
Summary
Orbital hemorrhage is a rare dacryocystorhinostomy (DCR) complication, often from anterior ethmoidal artery injury. Prompt recognition of globe resistance and potential surgical decompression are key for managing this serious event.
Area of Science:
- Ophthalmology
- Otorhinolaryngology
Background:
- Dacryocystorhinostomy (DCR) is a surgical procedure to restore lacrimal drainage.
- Orbital hemorrhage is a rare but severe complication of DCR.
Observation:
- Hemorrhage may result from injury to the anterior ethmoidal artery, which has a variable anatomical course.
- Increased resistance to globe retropulsion is a critical clinical sign of orbital hemorrhage.
Findings:
- Spontaneous resolution of orbital hemorrhage may occur.
- Surgical intervention, including direct decompression of orbital blood, may be necessary if the condition does not resolve spontaneously.
Implications:
- Understanding the risks associated with anterior ethmoidal artery proximity during DCR is crucial.
- Early recognition and management of orbital hemorrhage are vital to prevent vision-threatening complications.