Seconds Save Sight: Improving Orbital Compartment Syndrome Management Through a Closed-Loop Quality Improvement...

Introduction Orbital compartment syndrome is a rare but sight-threatening ophthalmic emergency requiring immediate recognition and intervention to prevent irreversible vision loss. Emergency lateral canthotomy and cantholysis remain the definitive treatment; however, the infrequent nature of the procedure means many ophthalmologists have limited practical experience and reduced procedural confidence. In addition to technical familiarity, delays in treatment may arise from difficulties locating emergency equipment within clinical environments. This quality improvement project evaluated clinician preparedness for the management of orbital compartment syndrome within a UK National Health Service (NHS) ophthalmology department and assessed the impact of introducing standardised emergency lateral canthotomy grab kits alongside focused educational teaching. Methods A single-centre closed-loop quality improvement project was undertaken within a UK NHS ophthalmology department. Clinicians of varying grades completed a baseline questionnaire assessing confidence in recognising orbital compartment syndrome, performing emergency lateral canthotomy, and locating the equipment required to undertake the procedure under time-critical conditions. Following baseline assessment, two interventions were implemented: a focused departmental teaching session reviewing recognition and management of orbital compartment syndrome and a dedicated emergency lateral canthotomy grab kit containing all equipment required for orbital decompression. A repeat survey was undertaken following implementation to evaluate changes in clinician preparedness, procedural confidence, and perceived accessibility of emergency equipment. Results Baseline findings demonstrated variable confidence in performing emergency lateral canthotomy and highlighted uncertainty regarding the location of essential equipment. Following implementation of the educational intervention and emergency grab kit, clinicians reported improved preparedness and procedural confidence. Around 92% of participants agreed that the introduction of dedicated grab kits improved procedural efficiency and accessibility, while all respondents reported being able to identify the equipment required to perform emergency lateral canthotomy following implementation. Conclusion This quality improvement project demonstrated that simple, low-cost interventions can improve clinician preparedness for the management of orbital compartment syndrome. Combining focused education with standardised emergency equipment may reduce avoidable delays during time-critical ophthalmic emergencies and represent an easily reproducible intervention that could be adopted across ophthalmology departments nationwide to improve the management of orbital compartment syndrome.