The characteristics of midfacial fractures and the association with ocular injury: a prospective study

Al-Qurainy, I.A.; Stassen, L.F.A.; Dutton, Gordon N.; Moos, K.F.; El-Attar, A.

doi:10.1016/0266-4356(91)90114-k

Cited by 256 publications

(141 citation statements)

References 31 publications

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“…25,26 Previous epidemiological data derived from multiple retrospective case series and the IONTS have indicated male preponderance, young age, and leading causes from RTAs, falls, and assaults in both adult 27 and paediatric 28,29 cohorts. Despite our study utilizing an effective active surveillance methodology that received high levels of support from the UK ophthalmologists, 30,31 there remained a certain level of underascertainment and consequently we are reporting minimum estimates of incidence rates.…”

Section: Epidemiologymentioning

confidence: 99%

Surveillance of traumatic optic neuropathy in the UK

Lee

Ford

Xing

et al. 2009

Eye

117

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Aims The aim of this study is to provide epidemiological data on the incidence, aetiology, management, and visual outcome in traumatic optic neuropathy (TON) in the UK. Methods Patients with TON were identified prospectively by population-based active surveillance through the British Ophthalmic Surveillance Unit over a 2-year period with data obtained from an incident questionnaire and follow-up questionnaire sent to positive reporters. Results Incident and follow-up data were available on 121 and 97 (80%) patients, respectively. The minimum estimated incidence was 1.005 per million. Leading causes included falls (25.6%), road traffic accidents (RTAs) (21.5%), and assaults (20.7%). The median age was 31 years. There were 95 (78.5%) men. Presenting visual acuity (VA) was 6/60 or worse in 85 (70%) patients, with 43 patients (36%) with no perception of light. Associated injuries included 47 (39%) orbital wall fractures, 37 (31%) closed globe injuries, 23 (19%) ocular adnexal injuries, 23 (19%) skull fractures, and 18 (16%) intracranial bleeding. Sixty-five percent (75/116) received no acute treatment and 35% (41/116) received steroids and/or surgery. Of the treated group, 24% (8/ 33) and of the untreated group 20% (11/56) improved three lines or more of VA (P ¼ 0.61). Prompt ophthalmic examination (P ¼ 0.002), orbital fracture (P ¼ 0.046), high Glasgow Coma Scale (GCS) score (P ¼ 0.023), and poor initial VA (P ¼ 0.009) were associated with increased likelihood of treatment. Poor initial VA (Po0.001), orbital fracture (P ¼ 0.004), and significant head injury (P ¼ 0.038) were associated with poor visual outcome. Conclusions This study suggested that young men were at greatest risk of TON. We detected a trend towards conservative management of this condition in the UK. TON was associated with significant ocular, orbital, and head injuries that highlighted the need for multidisciplinary management.

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Section: Epidemiologymentioning

confidence: 99%

Surveillance of traumatic optic neuropathy in the UK

Lee

Ford

Xing

et al. 2009

Eye

117

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“…7 Among the many possible eye injuries, some cases may involve decreased visual acuity, and as demonstrated in this case report, blindness may occur in up to 39.7% of these individuals. 8 The initial treatment of patients with these injuries should cover the basics of maintaining the airway and keeping the hemorrhage under control.…”

Section: Discussionmentioning

confidence: 70%

Treatment of a Penetrating Intraorbital Injury by Rubber Projectile

Pinto

Canto

Filho

et al. 2017

Craniomaxillofacial Trauma & Reconstruction Open

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Penetrating injuries caused by rubber projectiles are classified as low-velocity injuries. When the midface is affected, these can cause fractures, eye injuries, and even blindness. Unlike conventional projectiles, the removal of rubber projectiles involving the orbit and correction of associated fractures are mandatory for preventing infection and anophthalmic orbit syndrome, which is characterized by enophthalmos of the prosthesis, superior sulcus depression, and lower eyelid ptosis. This article aims to describe a case of penetrating injury by rubber projectile, associated with the removal and late reconstruction of the orbital walls, and to show the results obtained.

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“…The loss of vision in at least one eye was reported to be 6 % among 547 fractures of the facial skeleton [12], whereas Soyris et al [13], who reported 1,393 cases of malar fractures over a period of 20 years, recorded six cases of blindness and three of enucleation. Al Qurainy et al [14] studied 363 patients with midfacial fractures and found that 90 % of such patients sustained ocular injuries of various severity; 12 % experienced severe eye injuries. Whitaker and Yaremchuk [15] found 33 % of blindness or significant loss of vision among 78 patients who presented for secondary reconstruction of post-traumatic orbital deformities, presumably a selective group.…”

Section: Discussionmentioning

confidence: 99%