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The “Squeeze,” an Interesting Case of Mask Barotrauma

Published:December 06, 2017DOI:https://doi.org/10.1016/j.amj.2017.10.003
      An air medical team consisting of a paramedic and doctor crew was tasked by helicopter to an island hotel resort situated off the east coast of Australia. They responded to a 58-year-old man complaining of a persistent headache, left orbit fullness, and bilateral eyelid ecchymosis. Onset occurred before performing the Valsalva maneuver to relieve “mask squeeze” while scuba diving. This squeeze occurred at a 7- to 10-m depth, with initial discomfort and visual disturbance but relief on mask equalization. After surfacing from the dive, he complained of ongoing visual disturbance with diplopia. His past medical history included a metallic aortic valve replacement 20 years ago for which he is warfarinized. The concern of the tasking medical team was an expanding retrobulbar hemorrhage with impending visual loss and the potential for critical ischemia of the optic nerve.
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