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Orbital infarction during drug abuse: tissues of the globe do not appear to recover function

Eye volume 38, pages 198–201 (2024)Cite this article

Subjects

Abstract

Aim

To describe the features of an orbital infarction syndrome arising after prolonged orbital pressure during drug-induced stupor in young people.

Patients and methods

The clinical presentation and course for drug-induced orbital infarction is described, based on a retrospective review of clinical notes and imaging.

Results

Two cases of orbital infarction syndrome, due to prolonged orbital compression caused by sleeping with pressure on the orbit during drug-induced stupor, are described. Both patients presented with very poor vision and mydriasis, marked periorbital swelling with some pain, and complete external ophthalmoplegia. Whilst the orbital changes and eye movements recovered, the affected eyes had persistent wide mydriasis, and remained blind with marked optic atrophy.

Conclusion

With a mechanism analogous to prolonged orbital pressure due to improper head positioning during neurosurgical procedures, drug-users appear to risk developing an orbital infarction syndrome if they rest with prolonged pressure on the orbit during a drug-induced stupor.

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Fig. 1: (Case 1) Orbital imaging within days of a drug-induced prolonged compression of the left orbit, resulting in marked orbital swelling and a blind, “frozen” globe.
Fig. 2: (Case 2) Orbital radiography at presentation and late fundus appearance following orbital infarction after substance abuse.

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Author information

Authors and Affiliations

  1. Orbital Clinic, Moorfields Eye Hospital, London, EC1V 2PD, UK

    Amrita Sawhney, Kaveh Vahdani & Geoffrey E. Rose

Authors
  1. Amrita Sawhney
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  2. Kaveh Vahdani
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  3. Geoffrey E. Rose
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GER initiated the work; all authors contributed to data acquisition and writing.

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Correspondence to Kaveh Vahdani.

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Sawhney, A., Vahdani, K. & Rose, G.E. Orbital infarction during drug abuse: tissues of the globe do not appear to recover function. Eye 38, 198–201 (2024). https://doi.org/10.1038/s41433-023-02658-x

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