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Orbital compartment syndrome (OCS) refers to the compression of orbital contents due to an increasing volume within the orbital cavity. Of several potential mechanisms, a retrobulbar haemorrhage is the most common. OCS causes rapid ocular ischaemia and subsequent blindness and hence is an ocular emergency. It is essential that doctors are familiar with performing the sight-saving treatment of lateral canthotomy and cantholysis. At the lateral aspect of the eyelids, the body of the lateral canthal tendon is incised (lateral canthotomy) and the inferior arm of the tendon that inserts into the lower lid is disinserted (cantholysis). This releases the lower eyelid from the orbital rim, decompressing the orbit and reducing the pressure on the globe and its vascular supply. If symptoms do not promptly improve, cantholysis should be performed on the upper lid. We discuss OCS and a step-bystep of how to perform a lateral canthotomy and cantholysis.

Orbital Compartment Syndrome (OCS): An Ocular Emergency How to Perform a Sight-Saving Lateral Canthotomy and Cantholysis