Purchase this article with an account.
Sahebaan Sabharwal, Suhas Prabhakar, Ramya Ravindran; A prospective study on the incidence and pattern of orbital fractures and ocular complications in two wheeler drivers following road traffic accidents in South India. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5490.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Road traffic accidents are the most common cause of orbital fractures, the pattern of which is influenced by geographic area.With 80% of people in India using two wheelers and majority of them falling in the productive age group of 20-40 years, our study aims to understand the nature and presentation of such injuries so that the target population can be educated about the preventive measures.
50 patients, over 18 yrs presenting with injuries due to road traffic accidents while driving a two wheeler, over a period of 1 year were considered. Only those who sustained orbital fractures were included in the study. Detailed history was obtained and clinical examination done. Fracture sites were noted. Patients were treated and followed up for 4 months.
Majority of cases fell in the age group 20-40 with a male preponderance. Commonest nature of injury was direct collision with another vehicle. 57.69% had isolated lateral orbital wall fracture. Isolated medial wall in 35% followed by isolated roof and floor fracture in 3.85% each. In cases of multiple fractures, lateral orbital wall fracture combined with others was maximum in 76.32%. Most common ocular injury was SCH. Others were ecchymosis, diplopia, infraorbital dysasthesia, EOM restriction, enophthalmos, lid laceration, traumatic optic neuropathy and globe rupture. In a minor proportion we saw traumatic cataract,lens subluxation, penetrating foreign body, vitreous hemorrhage, retinal detachment, choroidal tears etc. At follow up, we found that 69% of eyes had normal vision. 37.08% had mild reduction in vision and 9.23% had severe reduction.1.53% became blind. 60% patients required surgical and 40% medical management. 52% underwent Open Reduction and IF. Most common persistent complication at the end of the follow up period was diplopia.
Lateral orbital wall fractures are the most common in two wheeler drivers following road traffic accidents in India and a whopping 95% of these patients have disabling ocular complications.This may be because lateral orbital wall, being the most prominent orbital structure, is the most susceptible to a direct impact.Since all of these patients had not been wearing helmets and a few were left handicapped for life, there surely is an urgent need to implement enhanced regulations and monitoring on motor vehicular traffic.
This PDF is available to Subscribers Only