Acute Orbital Compartment Syndrome (AOCS)

General: Usually due to a retrobulbar hematoma, which is most commonly secondary to trauma (blunt or penetrating) or retrobulbar anesthesia. Leads to rapid rise in intraocular pressure due to tethering of the globe by medial & lateral canthal tendons and is considered an emergent surgical opthalmologic condition (relieved with lateral canthotomy if the globe is intact) as the increased pressure compromises opthalmic artery flow. Permanent ischemic complications, including total vision loss, may occur by ~2 hrs.

Gross: Proptosis (usually unilateral) with periorbital swelling, conjunctival edema, and injected sclera. Usually there is associated obvious evidence of trauma.

Microscopic: Nonspecific hemorrhage.

Stains: Not generally relevant unless attempting to prove presence of globe rupture. ***

• Positive:
• Negative:
• Suggested, focused panel:

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