Traumatic Retrobulbar Haemorrhage: Aetio-pathology and management

Retrobulbar haematoma following blunt orbital trauma is a rare,but potentially serious complication, since it can evolve rapidly from visual impairment to permanent loss of vision. This sight-threatening situation most commonly arises from orbital bleeding accompanying undisplaced fractures of the orbital walls, an event that increases the pressure inside theorbit and results in vascular damage to the optic nerve. The clinical presentation includes pain, exophthalmos with proptosis, and internal ophthalmoplegia, with impairment or loss of the pupillary reXex. A thin-layer orbital CT scan is an essential diagnostic aid. Therapy is based on orbitaldecompression, via different surgical approaches, with the intention of reducing the pressure on the nerve and vascular structures inside the orbit. Emergent management is of utmost importance as any delay between the onset of symptoms and treatment can have a significant effect onrecovery