June 2015
Volume 56, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2015
Quantitative Assessment of Ocular Motility Disturbance in Orbital Blow-out Fractures
Author Affiliations & Notes
  • Jung Wook Lee
    Ophthalmology, Hanyang University Guri Hospital, Seoul, Korea (the Republic of)
  • EunHee Hong
    Ophthalmology, Hanyang University Guri Hospital, Seoul, Korea (the Republic of)
  • Moon sang won
    Ophthalmology, Hanyang University Guri Hospital, Seoul, Korea (the Republic of)
  • Heeyoon Cho
    Ophthalmology, Hanyang University Guri Hospital, Seoul, Korea (the Republic of)
  • Sei yeul oh
    Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea (the Republic of)
  • Yoon Duck Kim
    Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea (the Republic of)
  • Han Woong Lim
    Ophthalmology, Hanyang University Guri Hospital, Seoul, Korea (the Republic of)
  • Footnotes
    Commercial Relationships Jung Wook Lee, None; EunHee Hong, None; Moon sang won, None; Heeyoon Cho, None; Sei yeul oh, None; Yoon Duck Kim, None; Han Woong Lim, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 564. doi:
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      Jung Wook Lee, EunHee Hong, Moon sang won, Heeyoon Cho, Sei yeul oh, Yoon Duck Kim, Han Woong Lim; Quantitative Assessment of Ocular Motility Disturbance in Orbital Blow-out Fractures. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):564.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

To measure the range of ocular motility using modified limbus test (Fig 1) and to investigate the correlation with other factors in patients with blow out fractures.

 
Methods
 

We enrolled 35 subjects with orbital blow-out fractures who presented ocular motility disturbance. We measured the maximum angle of ocular movements in the positions of restricted motility of gaze using modified limbus test (Fig 2). We evaluated number of points of contact of extraocular muscles to the fracture edge (points of muscle contact) and the extent of blow out fracture based on CT. The correlation between the degree of ocular motility disturbance and the associated factors was estimated with linear regression analysis.

 
Results
 

The mean of the angle of ocular motility disturbance classified into grades 1,2,3, and 4 according to the clinical grage were 8.0±4.5°, 17.6±5.6°, 26.4±4.3°, and 40.2±8.3, respectively (P<0.001). The angle of ocular motility disturbance showed significant correlation with the clinical grading scale(R=0.730, P=0.015). The extent of blow out fracture and the number of points of contact of extraocular muscles to the fracture edge based on CT did not show significant correlation with the angle of ocular motility disturbance (R=0.250, P=0.127; R=0.453, P=0.072).

 
Conclusions
 

The modified limbus test using photographs in the cardinal positions of gaze is an objective and reproducible tool for quantifying ocular motility disturbance in the posttraumatic evaluation of orbital blow-out fractures. The extent of blow out fracture and number of points of contact of an extraocular muscle to the fracture edge are not enough to predict posttraumatic limitation of ocular movement in patients with blow out fractures in this study.  

 
Figure 1. Image processing by Photoshop and Image J for quantitative measurement of the ocular movement. A, Semitransparent image of depression was overlapped with the primary position image using Photoshop. B, The overlapping image was converted to identify the margin of the limbus using Photoshop. C, Geometrical analysis with Image J showing degrees of ocular rotation of the limbus.
 
Figure 1. Image processing by Photoshop and Image J for quantitative measurement of the ocular movement. A, Semitransparent image of depression was overlapped with the primary position image using Photoshop. B, The overlapping image was converted to identify the margin of the limbus using Photoshop. C, Geometrical analysis with Image J showing degrees of ocular rotation of the limbus.
 
 
Figure 2. An example of patient with blow-out fracture of right inferior wall. Semitransparent image of elevation was overlapped with the primary position image using Photoshop. The maximum angle of elevation in right eye (the injured eye) was 22.6° which was compared with 37.6° in left eye (the fellow eye).
 
Figure 2. An example of patient with blow-out fracture of right inferior wall. Semitransparent image of elevation was overlapped with the primary position image using Photoshop. The maximum angle of elevation in right eye (the injured eye) was 22.6° which was compared with 37.6° in left eye (the fellow eye).

 
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