Definition

What is a broken eye socket?

The eye socket is also called the orbit. While it feels like one solid structure, it consists of seven different bones that connect to create four different areas.

A fracture can occur in any one of these areas, creating different injuries:

  • Orbital rim fracture. These breaks occur in the outer edges of the eye socket. The orbital rim is very thick, so only extreme force, such as an injury from a car accident, can break it. This extra force can also injure the nerves, muscles, and connective tissues in the eye.
  • Direct orbital floor fracture. An orbital rim fracture may extend to the orbital floor to cause a direct orbital floor fracture. This will usually occur as a result of severe trauma.
  • Indirect orbital floor fracture. Also called a blowout fracture, an indirect orbital floor fracture typically occurs when an object, such as a steering wheel, fist, baseball, or elbow hits a person in the face. The impact leaves the bony rim of the socket intact but causes a hole in the floor of the eye socket. This hole can trap muscles, nerves, or other tissues, which makes it difficult for the eye to move and causes vision problems.
  • Trapdoor fracture. Trapdoor fractures generally only occur in children because their bones are more flexible. They are a type of orbital floor fracture. Instead of fracturing, the bones flex outward, then return to their normal position. While not technically a bone break, trapdoor fractures can still lead to severe and sometimes permanent damage.

How common is a broken eye socket?

Please discuss with your doctor for further information.

Symptoms

What are the symptoms of a broken eye socket?

The common symptoms of a broken eye socket are:

  • Double vision or reduced vision
  • Swelling of the eyelid
  • Pain, bruising, tearing, or bleeding around the eye
  • Nausea and vomiting (most common in trapdoor fractures)
  • Sunken or bulging eye, or droopy eyelid
  • Inability to move your eye in some directions

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.

Causes

What causes a broken eye socket?

Accidental injuries are the most common overall cause of eye socket fractures. Fractures to the thicker bones in the eye socket may be more common following traumatic events, such as falling from a height or having a car accident.

Sports injuries can cause a broken eye socket, especially sports where a ball or stick can hit the face. Using tools such as hammers, drills, and power saws may also increase a person’s risk of eye injuries.

Other causes include physical assaults and fighting. A punch or kick in the eye may be enough to lead to an indirect floor fracture if the pressure on the eye is too much for the thin bone to withstand.

Risk factors

What increases my risk for a broken eye socket?

Please discuss with your doctor for further information.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is a broken eye socket diagnosed?

In most cases, a doctor will make an initial diagnosis after physically inspecting the eye. They may also check eye pressure and ask questions about the person’s vision, such as whether the eye can look in all directions.

To help confirm the diagnosis, doctors use imaging tests like X-rays and CT scans.

The individual may need referring to a specialist to ensure that they receive comprehensive treatment. For example, an ophthalmologist can help diagnose vision damage, and a neurologist can advise on any nerve damage.

How is a broken eye socket treated?

Eye socket fractures don’t always require surgery. Your doctor will determine if your fracture can heal on its own.

You may be advised to avoid blowing your nose for several weeks after the injury. This is to prevent infection spreading from the sinuses to eye socket tissue though a small space in a fractured bone.

Your doctor may prescribe a nasal decongestant spray to help prevent the need for nose blowing or sneezing. Many doctors also prescribe antibiotics to prevent an infection from occurring.

Surgery

There’s some debate over the criteria for using surgery in blowout fractures. Here are some reasons surgery may be necessary:

If you continue to experience double vision for days after the injury, surgery may be needed. Double vision can be a sign of damage to one of the eye muscles that help move your eye. If the double vision goes away quickly, it was probably caused by swelling and doesn’t need treatment.

If the injury caused the eyeball to be pushed back in the socket (enophthalmos), this may be an indication for surgery.

If one half or more of the inferior wall was damaged, surgery will likely be needed to prevent facial deformity.

If surgery is needed, your surgeon may wait for up to two weeks after the injury to allow the swelling to go down. This allows for a more accurate examination of the eye socket.

The usual method of surgery is a small incision at the outside corner of your eye and one on the inside of your eyelid. An alternative method, endoscopy, is being used by a growing number of surgeons. In this procedure, surgical cameras and instruments are inserted through the mouth or nose.

This surgery requires general anesthesia, which means you’ll be asleep for the procedure and won’t feel any pain.

If you have surgery, you may be given the option of an overnight stay in the hospital or surgical facility. Once home, you’ll need assistance for at least two to four days.

Your doctor will likely prescribe oral antibiotics, corticosteroids like prednisone, and pain killers, usually for a week. The surgeon will likely advise you to use ice packs on the area for a week. You’ll need to rest, avoid blowing your nose, and avoid strenuous activity for at least two to three weeks after surgery.

You’ll be asked to return to the doctor within a few days after surgery, and probably again within the next two weeks.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage a broken eye socket?

The following lifestyles and home remedies might help you reduce your risk of a broken eye socket:

  • Use appropriate protective eyewear while working. Studies have shown that face shields, goggles and other protective eyewear can reduce the risk of work-related eye injuries by more than 90%.
  • Ask an experienced ophthalmologist, optometrist or optician for help in selecting appropriate protective eyewear for your sport. Baseball and basketball cause the greatest number of eye injuries.
  • Do not allow your child to participate in amateur boxing. The American Academy of Pediatrics opposes the sport of boxing for young people.
  • Always use a seat belt when you ride in a car, even if your car is equipped with airbags. Seat belts and shoulder harnesses will help to protect your eyes, facial bones and upper body from dashboard impacts and other injuries.

If you have any questions, please consult with your doctor to better understand the best solution for you.

 

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: August 24, 2018 | Last Modified: August 24, 2018

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