Do NOT delay treatment for diagnostic studies if there is already a high clinical suspicion for OCS
Tonometry (Tono-pen)
Do NOT use until globe rupture has been excluded
Normal pressure 10-20mmHg; pressure >35mmHg suggests OCS
Labs
CBC/BMP (if history of trauma or cellulitis)
Coag panel (coagulopathy increases risk for retrobulbar hemorrhage)
Imaging
CT (Orbit)
May help identify etiology or exclude diagnoses
75% of OCS cases will show a change in posterior globe configuration ("globe tenting")
Ultrasound (orbit)
Not been validated for AOCS, but may identify other ocular pathologies (retinal detachment, central retinal artery occlusion, lens dislocation, vitreous hemorrhage, and vitreous detachment
Do NOT use until globe rupture has been excluded
Normal pressure 10-20mmHg; pressure >35mmHg suggests OCS
CBC/BMP (if history of trauma or cellulitis)
Coag panel (coagulopathy increases risk for retrobulbar hemorrhage)
CT (Orbit)
May help identify etiology or exclude diagnoses
75% of OCS cases will show a change in posterior globe configuration ("globe tenting")
Ultrasound (orbit)
Not been validated for AOCS, but may identify other ocular pathologies (retinal detachment, central retinal artery occlusion, lens dislocation, vitreous hemorrhage, and vitreous detachment
May help identify etiology or exclude diagnoses
75% of OCS cases will show a change in posterior globe configuration ("globe tenting")
Not been validated for AOCS, but may identify other ocular pathologies (retinal detachment, central retinal artery occlusion, lens dislocation, vitreous hemorrhage, and vitreous detachment
Diagnosis can made clinically with afferent pupillary defect, vision loss, and intraocular pressure >35mmHg
Orbital compartment syndrome
Retinal detachment
Orbital fracture
Globe rupture
Labyrinthitis
Endophthalmitis
Orbital cellulitis
Optic nerve decompression