Post-traumatic eye observations

Retrobulbar haemorrhage after facial trauma or surgery is an uncommon but well-documented complication. The assessment and management of this condition is variable. We asked 288 maxillofacial surgeons in the UK about the signs and symptoms, incidence, and management of retrobulbar haemorrhage. We also enquired about the regimen that they used for eye observations, the patients who, in their opinion, required observation, and the method of communication of instructions to the nursing staff. A total of 185 responded (64%). Each surgeon had seen a mean of 1.3 cases of retrobulbar haemorrhage, of which most, n=190 (91%) were treated by surgery. There were 96 different eye observations regimens documented. There was a general consensus about the signs and symptoms, and 82 (44%) of respondents used a proforma for recording eye observations. On the basis of this study we recommend a standard regimen for eye observations, and have a designed a facial injury advice sheet to be given to patients who attend the accident and emergency department and are to be discharged home and followed up at a later date.