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August 2015

Self-induced Orbital Compression InjurySaturday Night Retinopathy

Author Affiliations
  • 1Vitreoretinal Diseases and Surgery Service, Department of Ophthalmology, Wills Eye Hospital, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
JAMA Ophthalmol. 2015;133(8):963-965. doi:10.1001/jamaophthalmol.2015.1114

Inadvertent compression of ocular tissues is an exceedingly rare cause of vision loss. Herein, we describe the second reported case, to our knowledge, of a self-induced orbital compression syndrome and the first set of images obtained with optical coherence tomography and fluorescein angiography in this condition.

An obese man in his mid-30s with no prior systemic or ocular disorders presented to a local emergency department after waking with no light perception OD. He also had pain, numbness, and erythematous induration of his right eyelids and forearm that increased throughout the day. The night prior to vision loss, he was drinking alcohol heavily and took 2 buprenorphine hydrochloride/naloxone hydrochloride pills. He denied any trauma. On presentation, he had acute renal failure due to rhabdomyolysis (creatinine level, 2.2 mg/dL [to convert to micromoles per liter, multiply by 88.4]; creatine kinase level, 29 320 U/L [to convert to microkatals per liter, multiply by 0.0167]) and had compartment syndrome of his right forearm for which he underwent an emergent fasciotomy.

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