Traumatic eye with late presentation of hyperaemic sclera with unilateral proptosis is due to:
Severe blunt trauma to the orbit can occasionally cause a retrobulbar hematoma. When a retrobulbar hematoma is large enough, it can cause an abrupt increase in intraocular pressure, causing decreased blood flow to the optic nerve and loss of vision. The conscious patient will complain of pain, proptosis, and decreasing vision. A CT scan of the orbit will demonstrate retrobulbar hemorrhage. An intraocular pressure >40 mm Hg is a consideration for emergency canthotomy. No matter what the intraocular pressure, if retrobulbar hematoma is suspected or confirmed, request emergency ophthalmology consultation. Ref: Walker R.A., Adhikari S. (2011). Chapter 236. Eye Emergencies. In J.E. Tintinalli, J.S. Stapczynski, D.M. Cline, O.J. Ma, R.K. Cydulka, G.D. Meckler (Eds), Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 7e.
Retrobulbar hematoma
Retrobulbar cellulitis
Carotico-cavernous fistula
Pneumo-orbit