An orbital compartment syndrome (OCS) may develop following significant burn injury. This can result in a marked increase in intraocular pressure with the potential for ischemic optic neuropathy and blindness.
Patient at risk: major burn injury
Risk factors for orbital compartment syndrome or complications:
(1) massive fluid resuscitation
(1a) > 0.25 L per kg of fluid infused during resuscitation
(1b) in excess of the amount predicted by the Baxter formula (0.004 L per kg per percent burned BSA)
(2) orbital trauma
(3) orbital burn injury
(4) failure to perform lateral canthotomy to relieve intraocular pressure
A patient who has received massive fluid resuscitation should have intraocular pressure monitored for the 72 hours following resuscitation. A lateral canthotomy should be performed if intraocular hypertension develops.
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