Compartment Syndrome

Compartment syndrome is a serious medical condition that occurs when pressure within a muscle compartment increases, leading to muscle and nerve damage. Causes

1. Trauma: Fractures, crush injuries, or severe blows to the muscle compartment.
2. Overuse: Repetitive strain or overuse of muscles, leading to increased pressure within the compartment.
3. Burns: Severe burns can cause compartment syndrome.
4. Surgery: Compartment syndrome can occur after surgery, especially if there is significant swelling or bleeding.

Symptoms

1. Pain: Severe, persistent pain in the affected limb or muscle compartment.
2. Swelling: Swelling or inflammation in the affected area.
3. Tightness: Feeling of tightness or pressure in the affected muscle compartment.
4. Numbness or tingling: Numbness or tingling sensations in the affected limb.
5. Weakness: Weakness or loss of function in the affected muscle.

Complications

1. Muscle damage: Prolonged compression can lead to permanent muscle damage.
2. Nerve damage: Compression can cause nerve damage, leading to numbness, tingling, or weakness.
3. Infection: Increased risk of infection due to compromised tissue.
4. Amputation: In severe cases, compartment syndrome can lead to amputation.

Treatment

1. Fasciotomy: Surgical procedure to relieve pressure by making an incision in the affected muscle compartment.
2. Pain management: Medications to manage pain and discomfort.
3. Physical therapy: Rehabilitation to restore muscle function and strength.
4. Monitoring: Close monitoring of the affected limb to prevent further complications.

Prevention

1. Proper wound care: Prompt and proper treatment of wounds to prevent infection.
2. Avoiding overuse: Gradually increasing exercise intensity and duration to avoid overuse.
3. Monitoring for symptoms: Recognizing early symptoms and seeking medical attention promptly.

Anyone with compartment syndrome, seek medical attention immediately. Prompt treatment can help prevent long-term damage. CALL 911

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The Cardinal eye manifestations of orbital compartment syndrome include:

• Acute onset of vision loss: This can range from blurred vision to complete loss of light perception.  
   
• Pain: Often described as severe and deep within or around the eye.   
   
• Proptosis: Bulging of the eyeball forward due to increased pressure in the orbit.   
   
• Resistance to retropulsion: The eyeball feels firm and is difficult to push back into the socket when gentle pressure is applied through the eyelid.  
   
• Elevated intraocular pressure (IOP): The pressure inside the eye is significantly higher than normal (typically >35-40 mmHg). 
   
• Decreased ocular motility (ophthalmoplegia): Difficulty or inability to move the eye in all directions.   
   
• Relative afferent pupillary defect (RAPD): The affected pupil does not constrict as much as the unaffected pupil when a light is shone into it. 
   
  Tight eyelids: The eyelids may be tense and difficult to open.  
• Periorbital swelling and ecchymosis: Swelling and bruising around the eye are often present, especially in cases of trauma.
• Chemosis: Swelling of the conjunctiva (the clear outer layer of the eye
   
• Subconjunctival hemorrhage: Bleeding under the conjunctiva, appearing as a red patch on the white of the eye.   
   
• On ophthalmoscopic examination:
  • Optic disc edema: Swelling of the optic nerve head.  
     
  • Retinal venous congestion: The veins in the retina may appear swollen and tortuous. 
  • Pulsation of the central retinal artery: This may be observed due to increased pressure.
  • In severe cases, central retinal artery occlusion (CRAO) can occur, leading to sudden and permanent vision loss.

It's crucial to recognize these signs and symptoms quickly, as prompt diagnosis and treatment (usually surgical decompression) are essential to prevent permanent vision loss in orbital compartment syndrom

Author

Paddy Kalish OD, JD and B.Arch