When is a retro-bulbar hemorrhage not a retro-bulbar hemorrhage?

Abstract

Clinical symptoms and signs of a retro bulbar haemorrhage (RBH) or oedema are periorbital pain, proptosis, decreasing visual acuity, restriction of eye movement and loss of direct light reflex. When these findings occur after facial trauma the diagnosis is traditionally thought to be that of RBH. However in the senior author's experience RBH has rarely been the cause of such findings. Instead this has been due to retrobulbar oedema requiring a different management approach. We therefore wish to challenge the concept that acute proptosis in trauma is usually RBH as currently believed.