Nose: retrobulbar haematoma after sinus surgery: practice question

A ENT question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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ENT · Nose: retrobulbar haematoma after sinus surgery

Sample item

Within hours of ethmoid surgery a patient has severe eye pain, tense proptosis, a fixed dilated pupil and falling visual acuity. What is the immediate management?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Urgent lateral canthotomy and cantholysis at the bedside

A retrobulbar haematoma raises orbital pressure and compresses the optic nerve and its blood supply, and sight can be lost within about 90 minutes. Treatment is immediate decompression by lateral canthotomy and cantholysis, with medical measures such as intravenous acetazolamide, mannitol and steroids and later surgical decompression.

Option by option

  • A. Wait for CT before any action

    Delaying for imaging risks permanent blindness.

  • B. Urgent lateral canthotomy and cantholysis at the bedside (correct)

    Correct. Rapid decompression saves vision.

  • C. Oral antibiotics and review next day

    Antibiotics do not relieve pressure.

  • D. Nasal decongestant spray only

    Decongestant does not decompress the orbit.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this ENT question

What is the answer to this ENT question?

The best answer is B, Urgent lateral canthotomy and cantholysis at the bedside. A retrobulbar haematoma raises orbital pressure and compresses the optic nerve and its blood supply, and sight can be lost within about 90 minutes.

Why is "Wait for CT before any action" not the answer?

Delaying for imaging risks permanent blindness.

Why is "Oral antibiotics and review next day" not the answer?

Antibiotics do not relieve pressure.

Why is "Nasal decongestant spray only" not the answer?

Decongestant does not decompress the orbit.

What concept does this question test?

It tests Nose: retrobulbar haematoma after sinus surgery in ENT. Treatment is immediate decompression by lateral canthotomy and cantholysis, with medical measures such as intravenous acetazolamide, mannitol and steroids and later surgical decompression.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Nose: retrobulbar haematoma after sinus surgery?

Learn tuning fork results and audiogram patterns by sketching them. Then use the flashcards and the other ENT questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.