Clinical Practice and Cases in Emergency Medicine

Introduction: Orbital compartment syndrome (OCS) is a rare but high-morbidity emergency requiring prompt recognition and management.

Case Report: We present a case of a man who developed OCS from external compression of the globe while lying in a prone position. Initially obtunded and unable to provide any history, the patient exhibited anisocoria, which later progressed to severe chemosis and proptosis. Intraocular pressure reached nearly 100 millimeters of mercury, improving immediately after emergent lateral canthotomy with cantholysis. His course was complicated by ipsilateral limb compartment syndrome and
worsening renal failure requiring dialysis.

Conclusion: This case highlights the critical role emergency physicians play in the rapid diagnosis and treatment of orbital compartment syndrome.