INTRODUCTIONAcute retrobulbar haemorrhage is a potentially sight-threatening condition, and can follow retrobulbar anaesthesia or trauma to the orbit. Acute loss of vision can occur with retrobulbar haemorrhage and is reversible if the condition is recognised and treated early.

CLINICAL PICTUREWe report a case of acute retrobulbar haemorrhage following orbital trauma in a 78-year-old Chinese lady.

TREATMENTThe patient was on follow-up for a mature cataract in the right eye and had been scheduled for cataract surgery. The patient presented to the emergency department with acute loss of vision in the right eye, severe proptosis and tense periorbital haematoma after she hit her right face following a fall. Computed tomography scans revealed fractures of the floor, lateral and medial walls of the right orbit as well as retrobulbar and periorbital haematoma. There was marked proptosis and tenting of the globe with stretching of the optic nerve. Emergent lateral canthotomy and cantholysis was performed at the emergency department. The patient subsequently underwent surgical evacuation of the orbital haematoma.

OUTCOMEThe patient's vision in the right eye recovered from no perception of light to light perception over the next few days. After a month of follow-up, the patient underwent right cataract surgery, and her best corrected visual acuity was 6/12 part.

CONCLUSIONIn severe acute retrobulbar haemorrhage, prompt surgical evacuation of the haematoma can reverse visual loss.

Accidental Falls ; Aged ; Decompression ; methods ; Facial Injuries ; complications ; Female ; Follow-Up Studies ; Humans ; Orbit ; injuries ; Retrobulbar Hemorrhage ; etiology ; physiopathology ; surgery ; Tomography, X-Ray Computed ; Visual Acuity ; physiology ; Visual Fields ; physiology

INTRODUCTIONThis study reviews the differences in demographics and surgical outcomes between ectropion in Asian and non-Asian eyes.

MATERIALS AND METHODSMedical records of surgically corrected ectropion cases from January 2002 to December 2006 were reviewed. Preand postoperative lid-globe apposition was graded: grade 0 with normal lid-globe apposition, grade 1 with punctal ectropion, grade 2 with partial lid eversion and scleral show, grade 3 with conjunctival hyperemia and thickening and grade 4 as for grade 3 with exposure keratitis.

RESULTSSixty-nine eyes in 50 patients underwent surgical correction of lower lid ectropion, making up 3.3% of all lid procedures performed. Eighty-four percent of patients were above 50 years of age, 72% were males and 88% were Chinese. Involutional change was the commonest aetiology, accounting for the majority of bilateral cases. The mean duration to surgery was 10.0 ± 16.0 months. The most frequent preoperative severity grade was 2. Lateral tarsal strip (LTS) was the commonest procedure performed, comprising 91.3% of eyes. The mean duration of postoperative review was 19.4 ± 19.2 months (range, 1 to 74 months). Postoperative improvement of at least one grade was observed in 98% while normal lid-globe apposition was achieved in 76% of eyes.

CONCLUSIONSInvolutional change is the most common cause of ectropion amongst both Asians and non-Asians. Ectropion is less prevalent amongst Asians as a result of anatomical differences and possibly reduced sun exposure. The LTS procedure is the most commonly performed surgical procedure for the successful correction of ectropion in both Asians and non-Asians.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; Blepharoplasty ; methods ; Child ; Child, Preschool ; Ectropion ; surgery ; Eyelids ; surgery ; Female ; Humans ; Infant ; Male ; Middle Aged ; Postoperative Period ; Preoperative Care ; Retrospective Studies ; Time Factors ; Young Adult