Oculocardiac reflex elicited by orbital floor fracture and inferior globe displacement

Chau M. Pham, Steven M. Couch

Research output: Contribution to journalArticle

4 Scopus citations

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.

Original languageEnglish
Pages (from-to)4-6
Number of pages3
JournalAmerican Journal of Ophthalmology Case Reports
Volume6
DOIs
StatePublished - Jun 1 2017

Keywords

  • Blow out fracture
  • Oculocardiac reflex
  • Orbital floor fracture

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