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Oculocardiac reflex elicited by orbital floor fracture and inferior globe displacement
Journal article   Open access   Peer reviewed

Oculocardiac reflex elicited by orbital floor fracture and inferior globe displacement

Chau M Pham and Steven M Couch
American journal of ophthalmology case reports, Vol.6(C), pp.4-6
2017
DOI: 10.1016/j.ajoc.2017.01.004
PMCID: PMC5722179
PMID: 29260043
url
https://doi.org/10.1016/j.ajoc.2017.01.004View
Published (Version of record) Open Access

Abstract

Purpose: To review the physiology, presentation and management of the oculocardiac reflex (OCR) by describing a case of the OCR associated with an orbital foreign body and complete ocular prolapse through a large orbital floor fracture in a 40-year-old male following a motor vehicle accident. Observations: The patient demonstrated marked bradycardia and hypotension necessitating intubation and medical therapy for autonomic shock. A computed tomography (CT) showed a total blow out floor fracture and complete dislocation of a radiographically intact globe with uninterrupted rectus muscle attachments into the left maxillary sinus. He was taken to the operating room for urgent repair resulting in subsequent termination of severe OCR. Conclusions and importance: The oculocardiac reflex can precipitate marked bradycardia and hypotension in the setting of trauma with significant orbital and maxillofacial injury. Prompt identification and management with vagolytic agents or definitive surgical intervention may prevent morbidity or mortality. Keywords: Blow out fracture; Oculocardiac reflex; Orbital floor fracture.
 Case report Blow out fracture Orbital floor fracture Oculocardiac reflex

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