Answer: VizD Challenge Week of 10/01/2007

*NY Emergency Medicine Exclusive*

Congratulations to Anh - he is the first person to submit the correct answer to this week's VizD. Anh is the winner of $5

View the VizD Question of the week.

This week, Dr Susi Vassallo, author of the seminal work on emergency canthotomy will discuss the answer to this weeks VizD

NYEM: When indicated, why is it so important to perform a lateral canthotomy?

Dr Vassallo: Performance of lateral canthotomy is critical to decompression of the orbit and relief of pressure on the optic nerve. Otherwise, there is risk for ischemia to the optic nerve resulting in blindness.

NYEM: In your opinion, what is the most important technical aspect in performing this procedure?


Dr Vassallo: The most important technical aspect in performing the procedure is palpating the lateral canthal tendon and cutting it. It is more easily palpated than visualized.

NYEM: How often do you see this procedure performed? (no pun intended)

Dr Vassallo: This procedure is performed more often than one would think. When I first wrote this article, Dr. Peter Rosen, then editor of the Journal of Emergency Medicine did not think it was an emergency medicine procedure. We happened to be talking years later when Dr. Rosen was practicing in Jackson Hole Wyoming. He told me that one of his former residents had to perform the procedure without ophthalmology assistance; this is when he realized it was important for emergency physicians to understand the indications for the procedure and to know how to do it.

NYEM: How does it feel that Roberts and Hedges Procedure book uses your article and images for their chapter on lateral canthotomy?

Dr Vassallo: I am happy to see the pictures from our article in the book by Roberts and Hedges. Jim Roberts is one of my hero clinicians.

NYEM: Thank you for your time!

Dr Vassallo: Of course, you are very welcome!

Stay tuned for a full interview with Dr Vassallo in a coming issue of NY Emergency Medicine

Thank you to everyone who participated!

For further reading on this procedure, please refer to Dr Vassallo's article in the Journal of Emergency Medicine












The next VizD will be posted on Monday October 22...sorry for the wait, but I will be at the ACEP meeting in Seattle and then hosting grand rounds!

VizD is a weekly contest of an interesting or pathognomonic image from emergency medicine. Its goal is to integrate learning into a fun and relaxed environment. All images are original and are posted with the consent of the patient. For more information please refer to the following link.