What is the first-line treatment for retrobulbar haemorrhage?

The first-line treatment for retrobulbar hemorrhage focuses on alleviating the increased intraocular pressure and preventing potential vision loss. The correct answer incorporates the use of mannitol, acetazolamide, and dexamethasone, which are effective in approaching this situation.

Mannitol is an osmotic diuretic that helps to rapidly lower intraocular pressure by drawing fluid out of the eye and into the bloodstream, thus reducing swelling in the orbit. Acetazolamide, a carbonic anhydrase inhibitor, further decreases the production of intraocular fluid, aiding in the reduction of intraocular pressure. Dexamethasone, a corticosteroid, is utilized to reduce inflammation and edema around the affected area.

In contrast, the other options either do not sufficiently address the urgent need to relieve pressure associated with retrobulbar hemorrhage or involve treatments that are not deemed first-line. Managing with ice packs, analgesics, and observation may be appropriate for mild cases but does not provide the necessary intervention required in instances where there is a risk of vision compromise. While antibiotics and topical steroids might have a role in certain infection-related concerns or inflammatory conditions, they do not specifically address the primary issue of retrobulbar hemorrhage itself.

Surgical