Emergency Lateral Canthotomy for Orbital Compartment Syndrome After a Motor Vehicle Collision at a Nontrauma Hospital

We present a case of a 60-year-old female patient who presented to a community hospital emergency department after a motor vehicle collision with car intrusion, with left eye proptosis, ecchymosis, decreased left-sided extraocular movement, and progressive eye pain. Clinical findings were consistent with orbital wall fracture and retrobulbar hematoma leading to orbital compartment syndrome (OCS). Lateral canthotomy was performed in the emergency department of an acute-care hospital without on-site ophthalmology prior to transfer to a tertiary care center. This case highlights the importance of recognizing OCS, which requires time-sensitive intervention to prevent permanent vision loss, and the ability of emergency physicians to perform the procedure in a suboptimal setting.