Andy Little, DO
Emergency Medicine
Associate Program Director
AdventHealth Orlando EM Residency Program
Orlando, FL
Twitter: @andyglittle
Objectives
- Discuss the indications for performing a lateral canthotomy
- Discuss the anatomy of the eye crucial to performing a lateral canthotomy
Outline
- Discuss the Indications for a Lateral Canthotomy
- Retrobulbar Bleed
- Decreased Visual Acuity
- Acute presentation of an Afferent Pupillary Defect
- Notable/New Proptosis
- Increased Intra-ocular Pressure
- > 40 mmHg
- Discuss the Complications/Contra-indications** of performing a lateral canthotomy
- Incomplete cantholysis
- Iatrogenic globe
- Surrounding structure injury (rare)
- Loss of adequate lower lid suspension
- Bleeding
- Infection
- Globe Rupture**
- Discuss the anatomy of the eye in relation to performing a lateral canthotomy
4. Discuss the materials needed to perform a lateral canthotomy
-
- Betadine prep
- Sterile drape or towels
- Lidocaine with epi
- Syringe with 27-30ga needle
- Normal saline for irrigation
- Straight hemostat or needle driver
- Iris or suture scissors
- Forceps
5. Provide step by step instructions to performing a lateral canthotomy
References:
- Rowh AD et al. Lateral Canthotomy and Cantholysis: Emergency Management of Orbital Compartment Syndrome. JEM 2015. PMID: 25524455
- Murali S. Orbital Compartment Syndrome – Pearls and Pitfalls for the ED Physician. REBEL EM Blog 2020. [Link is HERE]
Post Peer Reviewed By: Salim R. Rezaie, MD (Twitter: @srrezaie)
The post Rebellion21: SAVE the EYE – Lateral Canthotomy via Andy Little, DO appeared first on REBEL EM - Emergency Medicine Blog.