ORBITAL HEMATOMAS

Orbital hematomas may occur spontaneously, as a result of vascular ano malities, or they may be induced by trauma or occur following paranasa l sinus surgery. The retrobulbar hematoma requires special attention b ecause of its potential compression of the optic nerve may compromise vision or cause blindness. Patients and Methods: We report on four cas es: two subperiostal orbital hematomas, a spontaneous retrobulbar hema toma, and one orbital hematoma due to trauma. Results: In one case a v ascular anomality was detected by angiography. Though temporary blindn ess occurred in this case, it was possible to preserve 30% vision by s urgery. An infected subperiostal hematoma was successfully treated usi ng an endonasal approach. Two cases (a traumatic and a subperiostal or bital hematoma) required no operative treatment. Conclusions: The diag nosis of an orbital hematoma should be made as quickly as possible to permit adequate early therapy. Decrease of vision or blindness caused by orbital hematoma may be improved through a lateral canthotomy as em ergency measure and subsequently by draining the hematoma to relieve c ompression of the optic nerve.