Definition

What is an orbital fracture?

An orbital fracture is a traumatic injury to the bone of the eye socket.

There are three main types of orbital fractures that can occur:

  • Orbital rim fractures occur in the bony outer edges of the eye socket.
  • Blowout fractures occur when the rim stays intact, but a crack forms in the wafer thin bone that makes up the floor of the eye socket. The crack on the floor can pinch the eye muscles and nearby anatomy, preventing the eyeball from moving freely within the eye socket.
  • Direct orbital floor fractures are rim fractures that have extended into the floor.

How common is an orbital fracture?

Males are about four times more likely than females to sustain an orbital fracture. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of an orbital fracture?

The common symptoms of an orbital fracture are

  • Blurry, decreased or double vision
  • Decreased ability to look left, right, up or down
  • Black and blue eyes
  • Swelling of the forehead or cheek
  • Flattened cheeks
  • Intense cheek pain when opening the mouth
  • Bulging or sunken eyeballs
  • Facial numbness on the side of the injury
  • Bloated skin under the eye
  • Blood in the white part of the eye

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 an orbital fracture?

Fractures are typically caused by a blunt object striking the eye socket, such as a rock, baseball, hammer or fist. Orbital fractures continue to occur during car accidents.

Risk factors

What increases my risk for an orbital fracture?

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 an orbital fracture diagnosed?

Evaluation of patients with suspected orbital fracture should involve radiologic examination, motility test, diplopia field test and exophthalmometry. Plain X-ray films, although rarely used, with the Caldwell and Waters view may be done as a screening evaluation for possible fractures and foreign bodies. An orbital computed tomography, the gold standard in trauma, CT with contiguous thin axial and coronal sections should be ordered to confirm the diagnosis and plan for treatment. Three-dimensional CT reconstruction helps define facial bone anatomy and fractures clearly. Trapdoor fractures in pediatrics may not be noticed in CT scans, and in such cases, tear-drop sign, missing rectus sign, severe restriction of motion and oculocardiac reflex can be clues to diagnosing the fractures.

Serial evaluation of the diplopia field test and exophthalmometry are recommended as initial edema, hemorrhage and pain affect evaluation. A forced-duction test may help differentiate the causes of restriction of ocular movement, but one must be careful when interpreting the results. Severe edema or hematoma can mimic entrapment of tissues. The test is useful especially when it is done to judge the entrapment under general anesthesia during surgery.

How is an orbital fracture treated?

Oral antibiotic therapy may be considered. Fractures that involve the medial wall and floor may be considered open fractures, as laceration of the sinus mucosa is inevitable.

Analgesia and antiemetics may be required.

The use of oral steroids (prednisone 1 mg/kg/d) has been advocated to decrease soft-tissue edema.

For larger, more complicated fractures, especially those that impede eye movement, a ophthalmologist may perform surgical procedures to repair the fracture.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage an orbital fracture?

The following lifestyles and home remedies might help you cope with an orbital fracture:

  • For smaller fractures, ice packs, antibiotics and decongestants are usually enough to allow the eye socket to heal on its own.
  • Patients should avoid blowing their nose and performing Valsalva maneuvers to limit intraorbital emphysema.

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: October 25, 2017 | Last Modified: October 25, 2017

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