[Emergency therapy of traumatic orbital hematoma with acute visual impairment]

Midfacial injuries, surgery of the orbit or the paranasal sinuses as well as retrobulbar anesthesia can be the cause of a traumatic laceration of the ophthalmic artery and/or its branches prompting an extensive orbital hemorrhage with consecutive blindness. Since the neurosensory retina does not tolerate an ischemia of more than 1-3 hours, therapy has to be emergent: an extensive lateral horizontal canthotomy and vertical cantholysis, and if the hypertony of the globe persists, splitting of the periorbita in the temporal lower lid region are mandatory. The surgical details are presented.