Lateral canthotomy

  1. Gather equipment (lidocaine/syringe, hemostat, iris scissors, forceps)
  2. Cleanse the lateral canthus area
  3. Anesthetize the lateral canthus
  4. Crush the lateral canthus with a hemostat for 1-2 minutes
  5. Cut the lateral canthus (canthotomy)
  6. Pull the lower lid away from the globe with forceps
  7. Strum the tissue under the canthotomy to identify the inferior crus of the canthal tendon
  8. Cut the inferior crus of the canthal tendon (cantholysis)
  9. Re-check intra-ocular pressure (IOP)
  10. If IOP remains high (above 40), the superior crus of the canthal tendon may be cut in a similar manner
  11. Consult ophthalmology for repair and definitive management