Background: Ocular compartment syndrome (OCS) is a severe ophthalmological emergency that should be diagnosed and treated immediately to prevent permanent loss of vision. It is usually caused by a retro-orbital bleed that increases intraorbital pressure and threatens the patient's vision. This paper aims to present a rare case of OCS and the procedure of lateral canthotomy and acantholysis. Case Presentation: We present a 13-year-old boy who presented with facial injuries caused by a motorbike accident. The patient had vomited multiple times and was fully conscious. The patient had profound signs of increased intra-orbital pressure, which was found to be 70 mmHg. A significant right peri-orbital edema and ecchymosis of the right eye were present. The diagnosis of OCS was made, and lateral canthotomy with acantholysis procedure was performed. After the procedure, the pressure dropped, and vision was saved. Upon opening the eye, a flat retina, pale macula, and disc with intact venous pulsation were observed. Conclusions: This study highlighted the importance of diagnosing OCS as an ophthalmological emergency. Moreover, we discussed how to perform the sight-saving procedure of lateral canthotomy and cantholysis.

Keywords: Ocular compartment syndrome, intra-orbital pressure, lateral canthotomy, cantholysis, hematoma , eye trauma,