lateral canthotomy: quick refresher

20 May

Indications for emergent  lateral canthotomy

  • Retrobulbar hematoma with vision loss, proptosis, and increased intraocular pressure.
  • Contraindicated in globe injury patients.


Procedure Quick Hits:

  • Inject lido into lateral canthus, inject when needle touches bone.
  • Crimp skin at lateral canthus of eye with hemostat- hold for 1-2 minutes.
  • Hold skin up with hemostat and use scissors to dissect toward the lateral aspect.
  • Sometimes that is sufficient to decrease IOP.  If not, then pull lower eyelid out and locate lateral canthus tendon. Dissect this with scissors pointing out.


Submitted by Josh Rothstein.


References: emedicine article; picture1; picture 2

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