• Archives of Plastic Surgery
• /
• 제37권4호
• /
• pp.489-491
• /
• 2010

Purpose: Retrobulbar hemorrhage is a rare complication followed by blepharoplasty, trauma, orbital reconstruction, and so on. Most of the cases occur within 24 hours, half of them in the first 6 hours. Some authors have reported delayed retrobulbar hemorrhage after blepharoplasty and trauma within 1 day to 9 days. However, there have been few reports of delayed retrobulbar hemorrhage resulting from the complication of orbital reconstruction. Methods: A 22-year-old male underwent orbital floor reconstruction due to the orbital floor fracture. In 84 hours after the surgery, he complained sudden onset orbital pain and decreased visual acuity immediately after defecation. Intraocular pressure was unmeasurable due to the swelling at that time. Emergency computed tomography was performed. Results: Computed tomography revealed subperiosteal hematoma on inferior orbital wall extended to the apex. Emergency decompressive surgery was performed within 1 hour. After evacuation of hematoma, orbital symptom was improved and visual acuity was restored. Conclusion: Delayed retrobulbar hemorrhage is rare but vision-threatening. Therefore early diagnosis and treatment of delayed retrobulbar hemorrhage is thought to be crucial. The cause of delayed hemorrhage was not clear, however, valsalva maneuver might be the cause of hemorrhage.

• 대한두개안면성형외과학회지
• /
• 제22권2호
• /
• pp.110-114
• /
• 2021

Retrobulbar hemorrhage is a disastrous condition that can lead to permanent blindness. As such, rapid diagnosis and treatment are critical. Here, we report a patient who presented with retrobulbar hemorrhage following an orbital floor fracture. Restoration of inferior orbital wall with porous polyethylene implant was underwent. Four days after the orbital floor reconstruction, the patient smoked a cigarette outdoors in -3℃ weather. Cold temperature and smoking caused an increase in his systemic blood pressure. The elevated blood pressure increased intraorbital pressure to the extent of causing central retinal artery occlusion and exacerbated oozing. During exploratory surgery, 3 mL of hematoma and diffuse oozing without arterial bleeding were observed. Prompt diagnosis and treatment prevented vision impairment. Few studies have reported on the risk factors for retrobulbar hemorrhage. This case showed that daily activities, such as exposure to cold weather or tobacco smoking, could be risk factors for retrobulbar hemorrhage.

• 대한두개안면성형외과학회지
• /
• 제14권2호
• /
• pp.133-136
• /
• 2013

Retrobulbar hemorrhage is a rare but serious complication after blepharoplasty, mid-face injury, and treatment of facial bone fractures. The incidence of postoperative retrobulbar hemorrhage is 0.055% with an incidence of associated permanent blindness of 0.005%. A 69-year-old male came to the emergency room with pain on both orbital areas and uncontrolled bleeding after cosmetic lower blepharoplasty performed at a private clinic. He had not been evaluated preoperatively by the private clinic, but we found that he had undergone percutaneous transluminal coronary angioplasty and taken anticoagulants for 10 years. We performed an emergency operation to evacuate the hematoma. However, after surgery, he persistently complained of orbital pain, pressure and diminished visual acuity. Intraocular pressure was increased, and computed tomography demonstrated a retrobulbar hemorrhage with globe displacement. Emergent lateral canthotomy and cantholysis were performed. Intraocular pressure was decreased to 48/30 mm Hg immediately after the operation, falling within the normal range the next day. We recommend three points to minimize loss of vision by retrobulbar hematoma. Firstly, careful preoperative evaluation must be conducted including current medications, underlying diseases and previous history of surgeries. Secondly, cautious postoperative observation is important for the early diagnosis of retrobulbar hematoma. Lastly, immediate treatment is crucial to prevent permanent blindness.

• Archives of Plastic Surgery
• /
• 제40권4호
• /
• pp.445-449
• /
• 2013

Retrobulbar hemorrhage, especially when associated with visual loss, is a rare but significant complication after facial bone reconstruction. In this article, two cases of retrobulbar hematoma after surgical repair of blow-out fracture are reported. In one patient, permanent loss of vision was involved, but with the other patient, we were able to prevent this by performing immediate decompression after definite diagnosis. We present our clinical experience with regard to the treatment process and method for prevention of retrobulbar hematoma using a scalp vein set tube and a negative pressure drainage system.

• Journal of Korean Neurosurgical Society
• /
• 제44권3호
• /
• pp.156-158
• /
• 2008

Intraorbital hemorrhage is a rare clinical condition caused by orbital trauma, surgery around the orbit, intraorbital vascular abnormalities, and neoplasm. It was reported to occur spontaneously without any known causes and in association with orbital pseudotumor in a very few cases. A 59-year-old, female patient admitted with sudden onset of severe exophthalmos and pain on the left eye. Orbital CT and MR imaging suggested hemorrhage in the upper part of retrobulbar area of the left orbit. Cerebral angiography was taken to rule out any possible vascular abnormalities. On the left carotid cerebral angiography, the run-off of the distal ophthalmic artery was not seen and the engorgement of the supraophthalmic artery was noted. Systemic administration of corticosteroid did not improve the clinical status and craniectomy was done and retrobulbar hematoma was removed, and the clinical symptoms and signs were improved. Authors report a case of spontaneous intraorbital hemorrhage with the clinical features similar to those of orbital pseudotumor, requiring surgical decompression.

• Medical Lasers
• /
• 제9권2호
• /
• pp.184-186
• /
• 2020

Lower eyelid blepharoplasty is a popular facial rejuvenation surgery that restores the infraorbital region. The procedure is performed by removing excessive fatty tissues, muscles, and other unnecessary structures. The structure of the eyelid differs from person to person and is quite complex; therefore, numerous side effects are expected. Common lower eyelid blepharoplasty complications are asymmetrical faces, retrobulbar hemorrhage, blurred vision, and ectropion. This paper reports a case of a prominent periorbital vein after lower eyelid blepharoplasty. The prominent periorbital vein after surgery is a rare side effect that has not been reported to the best of the author's knowledge. This case was treated with a long-pulse 1,064-nm neodymium:yttrium-aluminum-garnet laser.

• Journal of Trauma and Injury
• /
• 제22권1호
• /
• pp.97-102
• /
• 2009

Purpose: Blunt trauma can cause a wide range of ocular injuries. This study was performed to describe the prevalence of severe intraocular injuries (SIOI) and their correlation with the severity of blunt orbital trauma. Methods: We retrospectively analyzed 117 eyes of 107 patients with orbital wall fractures who visited the emergency room at Konyang University Hospital from July 2006 to June 2008. Clinical features such as age, sex, causes of injury, revised trauma score (RTS), type of orbital wall fractures were recorded. The patients were divided into two groups: blowout fracture with severe intraocular injuries (SIOI) and blowout fracture without SIOI. We compared the clinical and the injury-related characteristics between two groups and analyzed the SIOS-related factors. Results: Among the 107 patients (117 eyes) with blowout fractures, 29 (27.1%) patients with 32 eyes (25.6%) had complicated severe intraocular injuries. Retrobulbar hemorrhage (14.5%), hyphema (13.7%), traumatic optic nerve injury (4.3%), and sustained loss of visual acuity (4.3%) were the most common SIOI disorders. A logistic regression analysis revealed that loss of visual acuity (odds ratio = 4.75) and eyeball motility disorder (odds ratio=7.61) were significantly associated with SIOS. Conclusion: We suggest that blowout fracture patients with loss of visual acuity or eyeball motility disorder are mostly likely to have severe intraocular injuries, so they need an ophthalmologic evaluation immediately.

• Tuberculosis and Respiratory Diseases
• /
• 제43권2호
• /
• pp.236-242
• /
• 1996

두개내 결핵성 육아종은 흉부, 복부 또는 요로 생식계에 있는 원발성 결핵으로 부터 결핵균이 혈행성으로 전파되어 생긴다고 하였으며, 주로 폐를 통해 침입하여 발생한다. 임상적으로 두통과 경련등의 증상을 보여 뇌종양의 양장으로 나타난다. 저자들은 속립성 결핵의 치료도중에 발생한 두통 및 현훈과 시력장애을 주소로 내원한 25세 여자환자의 뇌 자기공명영상으로 진단한 두개내 결핵성 육아종과 함께 안과 소견상 망막의 화염상출혈과 유두부종 및 시야검사상 양측두부의 반맹증과 중심암점으로 시신경의 결핵성 육아종을 의심하여 안구내의 steroid의 투약과 함께 항 결핵제제의 계속적인 투약으로 증상호전을 보인 증례을 경험하였기에 문헌고찰과 함께 보고하는 바이다.