Orbital Fracture and Traumatic Injury

Orbital fractures are breaks in any of the bones surrounding the eye area (also known as the orbit or eye socket). These fractures are almost always a result of a blunt force trauma injury, whether by accident or from sports. Orbital fractures can cause a multitude of issues depending on where they are located and what other associated injuries may be present. Because of this, close ophthalmic assessment is paramount to see which fractures may require correction in order to restore normal visual function.

Types of Orbital Fractures

Orbital fractures can be classified into three distinct types:

• Blowout Fracture – The most commonly encountered, a blowout fracture occurs in the eye socket along the floor or inner wall near the nose and is often due to something hitting the eye with force, like a tennis ball or racquetball. These fractures may be asymptomatic and can be observed or cause problems with double vision, or a change in the position of the eyeball, and require surgical repair.
• Orbital Rim Fracture – These fractures are located on the outer edges of the eye socket and require a large amount of force to inflict. Orbital rim fractures are often the result of car accidents, accompanying other injuries to the head and face, and may present as an irregular contour along the edge of the eye socket.
• Compound Fractures – Trauma to the midface may result in a combination of fractures including the orbital rim, floor, and cheek, and may be referred to as a tripod or ZMC (zygomaticomaxillary complex) fracture. This may affect both the eye socket and the maxilla or upper jaw, resulting in abnormalities in biting or chewing. Other compound fracture associations include the bones of the nose, calvarium (chamber that contains the brain), and skull base.

Symptoms of an Orbital Fracture

Symptoms of orbital fractures are dependent on the type of fracture and can include:

• Blurred Vision
• Double Vision
• Bruising Around the Eyes
• Swelling
• Facial Numbness
• Difficulty and/or pain moving the eye
• Nausea and/or vomiting worsened by eye movements
• Bulging or Sunken Eyeballs
• Sunken Cheek

Diagnosis

In order to diagnose the type and severity of the orbital fracture, a Dean McGee Eye Institute (DMEI) ophthalmologist will examine the eye and surrounding area, take pictures to check your progress, and review or order CT scans, if necessary. They will also check the eye’s positioning in the eye socket and assess if it moves properly.

How Are Orbital Fractures Treated?

For many orbital fractures, surgery is not necessary. Your ophthalmologist may recommend the use of ice packs to reduce swelling, along with decongestants and antibiotics. Sneezing with the mouth open, avoidance of nose blowing, or vigorous straw usage are necessary for several weeks to prevent further injury.

If the fracture has affected movement, function, or placement of the eye, reconstructive surgery may need to be performed.