title: Intraocular pressure changes in emergent surgical decompression of orbital compartment syndrome.
abstract: OBJECTIVE
  Orbital compartment syndrome is an acute rise in intraorbital volume resulting in increased intraorbital pressure and possible ischemic compromise of the optic nerve. Tonometric pressure measurement of intraocular pressure can aid surgeons in the diagnosis of this condition and in choosing the need to proceed with emergent surgical intervention. In addition, we present an unexpected cause of orbital compartment syndrome following routine frontal sinus irrigation.
  
  
  METHODS
  An emergent lateral canthotomy and cantholysis followed by endoscopic medial wall decompression were performed, with intraocular pressure measurements performed throughout the evolution of this successful, and vision sparing, set of procedures. The techniques and continuous improvements in intraocular pressure measurements are described.
  
  
  CONCLUSIONS
  There are only rare reports of the progression of intraocular pressure prior to, and concurrent with, surgical orbital decompression. While no absolute threshold for intraocular pressure exists for when surgical decompression should be performed, the decision of when and which decompression procedures to undertake should be based on clinical judgment and experience. Availability of tonometry in the operating room serves to measure response to management in these rare but challenging settings where intervention may be required to prevent irreversible visual loss.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, California.
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Mohammadi
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, California.
authors.forename: Ali
authors.initials: A
authors.lastname: Rashan
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, California3Department of Otolaryngology-Head and Neck Surgery, University of Adelaide, Adelaide, South Australia, Australia.
authors.forename: Alkis
authors.initials: A
authors.lastname: Psaltis
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, California.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Janisewicz
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, California.
authors.forename: Peter
authors.initials: P
authors.lastname: Li
authors.affiliation: Department of Ophthalmology-Oculoplastics Service, Stanford University School of Medicine, Stanford, California.
authors.forename: Tarek
authors.initials: T
authors.lastname: El-Sawy
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, California.
authors.forename: Jayakar V
authors.initials: JV
authors.lastname: Nayak
mesh_terms: D002908:Chronic Disease; D003161:Compartment Syndromes / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D019299:Decompression, Surgical / Q000379:methods; D004487:Edema / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D004724:Endoscopy / Q000009:adverse effects; D005260:Female; D006801:Humans; D007429:Intraocular Pressure; D008875:Middle Aged; D009798:Ocular Hypertension / Q000000981:diagnostic imaging / Q000209:etiology*; D009916:Orbital Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D011859:Radiography; D012220:Rhinitis / Q000601:surgery*; D012852:Sinusitis / Q000601:surgery*; D007507:Therapeutic Irrigation / Q000009:adverse effects*