Adam  Hauch,Thomas L.  Hauch,
Retrobulbar Hemorrhage: A Critique
Surgical Case Reports
2019
2613-5965
http://dx.doi.org/10.31487/j.SCR.2019.02.014
https://www.sciencerepository.org/retrobulbar-hemorrhage-a-critique_SR-SCR-2019-2-114 
Abstract: Introduction: Retrobulbar hemorrhage is a rare, progressive, sight-threatening emergency. Standardized
treatment algorithms for it exist in the literature; however, their efficiency is uninterpretable in most nonophthalmic settings. This paper reviews retrobulbar bleeding, the pathophysiology of vision loss, and the
therapeutic modalities and their efficacy in addressing such visual damage.
Case Report: We present the unfortunate case of an 82-year-old male with coronary artery disease on
anticoagulants who presented for a vitrectomy for a vitreous hemorrhage secondary to eccentric disciform
degeneration under general anesthetic with an accompanying retrobulbar block. He subsequently developed
a retrobulbar hemorrhage at some point post-operatively. He presented to his surgeon 18-hours after the
operation with no light perception on ophthalmologic examination as well as facial ecchymosis and
proptosis. Efforts to reduce his intraocular pressure were successful, but there was no return of vision.
Conclusion: Retrobulbar hemorrhage can be a devastating visual event. Standardized treatment algorithms
have been described, however, the effectiveness or need of such treatments can only best be evaluated by
an ophthalmologist and are often performed too late to provide meaningful recovery. Keywords: Retrobulbar hemorrhage, orbital hemorrhage, orbital compartment syndrome intraocular pressure