<p>Review of Ocular Injuries in Patients with Orbital Wall Fractures: A 5-Year Retrospective Analysis</p>

Abstract

a level-one trauma center, to help determine the most appropriate setting for the initial dilated fundus examination by ophthalmologists. Methods: A retrospective study was performed from January 2008 to January 2013 of patients diagnosed with orbital wall fracture secondary to trauma. Exclusion criteria included unknown mechanism of injury, the absence of ophthalmology consultation, or absence of imaging. Data collected included age, gender, mechanism of injury, visual acuity, and anterior/ posterior segment findings. Ocular injuries were categorized as either minor or major. Results: Of 567 charts reviewed, 460 met criteria and were included for analysis. In the analysis, 86.5% of patients were male, and 81.3% were Caucasian. The most common mechanism of orbital fracture was blunt injury. Visual acuity was better than 20/100 in 82.4% of patients. On chart review, 81.1% of patients were found to have either a minor injury, a major injury, or both. The most common injury was subconjunctival hemorrhage (53.5%). Globe rupture (2.9%) and vision-threatening posterior segment findings such as retinal tear and choroidal rupture (1.3%) were relatively rare. Only one retinal detachment (0.2%) was found, specifically in the setting of severe injury with concomitant globe rupture. Conclusion: Knowledge of the common ocular injuries associated with orbital fractures will help emergency department (ED) physicians and ophthalmologists provide the dilated fundus exam in the most appropriate setting. The most frequent injuries identified were non-vision threatening, and visually significant posterior segment findings were relatively rare (1.3%). Thus, for the majority of patients presenting to the ED with orbital fracture, a dilated fundus exam can be performed at a later date in the outpatient clinic setting, unless urgent orbital fracture surgery is planned.

Review of 451 Patients Presenting With Orbital Wall Fractures: A Retrospective Analysis

“…This is in contrast to other studies showing orbital roof fractures occurring in men 89% to 93% of the time and usually caused by high-energy impact injuries. 8 This could be due in part to a smaller sample size presenting with orbital roof fractures; however, the fractures being caused by high energy impact injuries are consistent with our study which showed that superior wall orbital fractures were more frequently caused by forms of direct impact and MVCs.…”

“…Our data follows the literature that a very small percentage of orbit fractures require surgical correction 8,28. Open reduction and internal fixation was the procedure of choice to repair all orbital fractures and was by far the most commonly utilized procedure in our study representing 57.9% (44/76) of the surgical interventions that were done.…”

“…Fractures of the orbit can occur from various types of periocular trauma and are important to identify early and given appropriate care for best outcomes 8. There are several different types, presentations, degrees of severity, and management strategies of different ocular injuries.…”

Detection of Abnormal Spontaneous Brain Activity Patterns in Patients With Orbital Fractures Using Fractional Amplitude of Low Frequency Fluctuation

“…Conservative treatment is often used for small orbital fractures without displacement ( 7 ), while, for large displaced fractures, surgical intervention is necessary ( 8 , 9 ). Orbital fractures may cause exophthalmos ( 10 ), enophthalmos ( 11 ), diplopia ( 12 ), entropion ( 13 ), subconjunctival hemorrhage ( 14 ), and even blindness ( 15 ). Therefore, early monitoring and termination of adverse disease progression in patients with OF are very important.…”

Detection of Abnormal Spontaneous Brain Activity Patterns in Patients with Orbital Fractures using Fractional Amplitude of Low Frequency Fluctuation

“…Conservative treatment is often used for small orbital fractures without displacement [7], while for large displaced fractures surgical intervention is necessary [8,9]. Orbital fractures may cause exophthalmos [10], enophthalmos [11], diplopia [12], entropion [13], subconjunctival hemorrhage [14] and even blindness [15]. Therefore, early monitoring and termination of adverse disease progression in patients with OF is very important.The use of modern imaging technology to study the brain activity of patients with OF may be important as a means by which to improve understanding of the mechanism of potential pathological changes in this condition, and may therefore be bene cial to the management of complications.…”