April 2011
Volume 52, Issue 14
ARVO Annual Meeting Abstract  |   April 2011
Indications For CT Scan In Patients with Trauma
Author Affiliations & Notes
  • Yogita Kashyap
    Ophthalmology, The New York Eye & Ear Infirmary, New York, New York
  • Alberto Distefano
    New York Medical College, Valhalla, New York
  • Krishna Mukkamala
    Ophthalmology, New York Eye and Ear Infirmary, New York, New York
  • David Della Rocca
    Ophthalmology, The New York Eye & Ear Infirmary, New York, New York
  • Footnotes
    Commercial Relationships  Yogita Kashyap, None; Alberto Distefano, None; Krishna Mukkamala, None; David Della Rocca, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 5587. doi:
  • Views
  • Share
  • Tools
    • Alerts
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Yogita Kashyap, Alberto Distefano, Krishna Mukkamala, David Della Rocca; Indications For CT Scan In Patients with Trauma. Invest. Ophthalmol. Vis. Sci. 2011;52(14):5587.

      Download citation file:

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

  • Supplements

Purpose: : A computed tomography scan (CT) is the current gold standard for the diagnosis of orbital fractures. Given the recent heightened awareness of radiation exposure associated with CT imaging, we reviewed the yield of orbital CT scans in patients with orbital trauma presenting to a tertiary care eye center.

Methods: : Retrospective case series. All consecutive orbital CT scans between 2008 and 2010 that were performed after orbital trauma were reviewed. Demographics, patient symptoms, and physical exam findings were noted.

Results: : The charts of 107 patients with CT scans for orbit trauma were reviewed. 50 patients (47%) had radiographic evidence of a fracture (average age 30±13.8 yrs, 88% male, 48% Caucasian, 20% Hispanic). 57 patients (53%) had no fracture on CT scan (average age 43±20.7 yrs, 61% males, 54% Caucasian, 23% Hispanic). The following signs and symptoms were associated with fracture: 88% with complaints of binocular diplopia, 39% of patients without diplopia had a fracture (p<0.001), 92% of patients with extraocular motility restrictions in any gaze, 32% of patients with full motility (p<0.001), 73% with commotio retinae, 42% of those without commotio retinae (p<0.05), 73% of those patients with peri-orbital hypoesthesia, 44% of those without complaints of hypoesthesia (p=0.06), 50% of those patients with 2 mm or greater difference in Hertel exophthalmometry between affected and unaffected eyes, 46% of those less than or equal to 2mm difference. Of the 50 patients with fractures, three patients required surgical repair.

Conclusions: : We have established that in patients with commotio retinae, binocular diplopia, and restriction of extraocular movements, performing an orbital CT scan after trauma is likely to reveal radiographic evidence of an orbital fracture. This imaging is required for surgical planning. Only three of the 107 patients who underwent a CT scan underwent surgical repair, perhaps refining clinical features that are associated with a fracture could change the current practice pattern of using a CT scan for all orbital trauma patients. These results will form the basis of a prospective trial comparing the utility of an orbit CT scan to a facial X-ray, which poses a lower radiation risk, as a screening image for trauma.

Keywords: orbit • imaging/image analysis: clinical 

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.