Skip Navigation LinksHome > August 2013 - Volume 21 - Issue 4 > Management of the ‘tight orbit’ and associated visual loss
Current Opinion in Otolaryngology & Head & Neck Surgery:
doi: 10.1097/MOO.0b013e32836312a1
MAXILLOFACIAL SURGERY: Edited by Sherard A. Tatum

Management of the ‘tight orbit’ and associated visual loss

Alford, Eugene L.a,b,c,d; Soparkar, Charles N.S.b,c,e,f,g

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Abstract

Purpose of review: To review the most recent literature on the management of the orbit under high pressure (the tight orbit) with threatened visual loss.

Recent findings: Definitive management of traumatic optic neuropathy remains unclear, lacking randomized head-to-head treatment option trials. Instead, numerous case series and anecdotal reports show benefit in each of the four treatment modalities currently in use, but a multitude of variables confound cross-study comparison. In contrast, the management of orbital hemorrhage and orbital emphysema is well known. A number of immunomodulatory protocols have recently arisen for the medical suppression of Graves’ ophthalmopathy, but when surgical decompression is required, most authors currently favor a combined transconjunctival and endoscopic endonasal approach.

Summary: This article reviews the anatomy, pathophysiology, diagnosis, and intervention of the ‘tight orbit’ with associated visual loss. Guidelines for the intervention are given.

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

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