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Clinical Summary

Mask squeeze results when a diver fails to maintain the balance between the air pressure within the mask and the external water pressure during descent. If a diver descends without equalizing pressure by exhaling through the nose, significant negative air pressure will exist inside the mask. The net result may include rupture of capillary beds, leading to conjunctival hemorrhage and skin ecchymosis.

Management and Disposition

Treatment consists of ascent and supportive care. A history of recent eye surgery or use of anticoagulant medication should be sought. A thorough eye examination should be performed and ophthalmologic consultation considered if warranted.

Pearls

  1. Diver education and proper diving technique minimize the risk of mask squeeze.

  2. Special consideration should be given to patients with anticoagulant use or recent keratotomy, as corneal incisions heal relatively slowly.

FIGURE 16.97

Mask Squeeze. Mask squeeze in a diver who descended to 45 FSW without exhaling into his mask. (Photo contributor: Kenneth W. Kizer, MD; reprinted with permission from Auerbach PS (ed). Wilderness Medicine: Management of Wilderness and Environmental Emergencies. 3rd ed. St. Louis, MO: Mosby-Year Book; 1995. Copyright © Elsevier.)

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