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In the Eye of the Beholder

Question: A 42 year old woman undergoes endoscopic sinus surgery for chronic rhinosinusitis with nasal polyposis. Intraoperatively, the lamina papyracea is breached without violation of the periorbita. In the recovery room, she has normal extraocular movements and visual acuity, and no issues with vision. On postoperative day 2 she develops proptosis and eye pain after initiation of nasal irrigations. What is the next step in management?

a) Observation

b) Anti-inflammatory medications (ibuprofen, steroids)

c) Canthotomy and cantholysis

d) Measurement of intraocular pressure and CT scan

[Answer will be posted with next week's new question]

Answer to last week's question, “Zip It Up” (February 8, 2021)

C - Muscle, mucosa, and skin at and above/below vermillion border.