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Updated: Nov 3, 2025

Full-Circle Cauterization of Limbal Vascular Plexus for Surgically Induced Glaucoma in Rodents
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Doubly Blinded: An Uncommon Cause of Acute Visual Loss Due to Orbital Compartment Syndrome

Khalid Sawalha1, Devi Nair2

  • 1Internal Medicine Division, White River Health System, Batesville, AR 72501, USA.

Clinics and Practice
|June 2, 2021
PubMed

Insights

A patient experienced vision loss after Watchman device implantation due to a left orbital hematoma. Despite prompt intervention, including canthotomy, the vision loss was irreversible, highlighting a rare complication of left atrial appendage closure.

Area of Science:

  • Cardiology
  • Ophthalmology
  • Neurosurgery

Background:

  • A 68-year-old female with atrial fibrillation on anticoagulation (Apixaban, Clopidogrel) underwent Watchman device implantation due to high fall risk.
  • Left atrial appendage (LAA) closure is an alternative to long-term anticoagulation for stroke prevention in atrial fibrillation.

Observation:

  • One hour post-procedure, the patient developed left-sided diplopia and severe eye pain.
  • A CT scan revealed a left superior orbital mass, consistent with a hematoma.

Findings:

  • An urgent bedside left canthotomy with cantholysis was performed to address the orbital mass.
  • Despite rapid intervention, the patient suffered irreversible vision loss in the left eye.

Implications:

  • This case highlights a rare but severe complication of Watchman device implantation, potentially related to anticoagulation or the procedure itself.
  • Ophthalmologic monitoring and prompt surgical intervention are critical in managing orbital complications post-LAA closure.
  • Further investigation into the mechanisms of orbital hematoma formation after LAA closure is warranted.

Keywords:
orbital compartment syndromeretrobulbar hematoma

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