Prevention and management of orbital hematoma.

Orbital hematoma is an uncommon but serious complication of sinus surgery. Appropriate perioperative attention may minimize risk, but early diagnosis and appropriate management are crucial to preventing vision loss. The surgeon, postoperative care staff, and patient must be aware of the signs and symptoms. Immediate examination must be performed, including pupil size, symmetry, and reactivity, visual acuity, and measurement of intraocular pressure. Immediate consultation from an ophthalmologist or oculoplastic surgeon is mandatory if the diagnosis is suspected. The surgeon and ophthalmologist should follow an algorithm of advancing therapies based on serial examination, ranging from observation only to immediate surgical intervention.