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Recurrent vision loss after endoscopic sinus surgery managed with palmar pressure
Jonathan E Silbert1, Danielle S Rudich, Eric L Wasserman
1Department of Ophthalmology, Yale University, New Haven, CT, USA. jonsilbert@comcast.net
Ophthalmic Plastic and Reconstructive Surgery
|March 22, 2008
Summary
Acute orbital emphysema after surgery can cause vision loss. A simple bedside palmar pressure technique successfully restored vision, avoiding invasive procedures.
Area of Science:
- Ophthalmology
- Otorhinolaryngology
Background:
- Endoscopic sinus surgery can lead to rare complications.
- Orbital emphysema, characterized by air in the orbital tissues, can compromise vision.
Observation:
- A patient developed acute orbital emphysema with vision loss 24 hours post-endoscopic sinus surgery.
- CT imaging revealed medial orbital wall disruption and orbital fat herniation.
Findings:
- Immediate bedside palmar pressure applied to the globe resulted in complete vision restoration.
- The patient experienced two subsequent episodes of transient monocular vision loss, both resolved with palmar pressure.
Implications:
- Bedside digital decompression is a potentially effective, non-invasive treatment for vision loss due to orbital emphysema.
- This simple procedure may obviate the need for needle aspiration or surgical decompression.
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