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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. doi: https://doi.org/.
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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.
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.
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).
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.
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