Purchase this article with an account.
CR Bernardino, EL Chang, AM Fay, PA D Rubin; Orbital Fractures Associated with Ocular Trauma - Clincal Features . Invest. Ophthalmol. Vis. Sci. 2002;43(13):3043.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Introduction: Trauma to the orbit can cause many injuries including fractures to the orbital walls and damage to ocular structures. Although injury to both the orbital bones and eye happen frequently, few studies have analyzed the association of ocular trauma with fractures to specific orbital bones. This study investigates whether ocular trauma is associated with certain fracture patterns of the orbit. Purpose: To determine the likelihood of a floor, medial, lateral, or roof fracture due to trauma associated with eye injury versus trauma without ocular damage. Methods: A retrospective, non-sequential chart review of 40 patients referred during the period of January 1998 to December 2001 for orbital fracture to the Oculoplastics Service at Massachussetts Eye and Ear Infirmary was performed. Patient demographics, mode of injury, CT findings, and the presence of orbital and ocular trauma were analyzed. Significant ocular injury was defined as injury which was vision threatening like hyphema, traumatic cataract, or commotio retinae. Results: Out of forty patients, the floor was fractured in 38, followed by the medial wall in 16, the lateral wall in 4 and the roof in 3 patients. Significant ocular injury was seen in 15 of 40 subjects (37.5%). Medial wall fractures were associated with ocular trauma in 57.1% of patients (8), while floor involvement was associated with ocular trauma in 36.8% of subjects (14). Ocular injuries were associated with a medial wall/floor fractures combination in 46.7% of cases (7); this fracture pattern was seen without ocular trauma in 20% (5 of 20). Enophthalmos was more prevalent in those with ocular trauma (53.3%) versus those without ocular injury (20%). Conclusion: In our study, the frequency of combined medial wall/floor fractures and enophthalmos was higher in patients who sustained an ocular injury. Furthermore, the percentage of patients having a medial wall fracture and ocular injury was higher than those with had a floor fracture with ocular trauma. Experimental models of orbital fractures including hydraulic (forces transmitted through the eye to the orbital walls creating multiple, large fractures), and buckling (forces transmitted from the orbital rim to the orbital bones causing small, isolated fractures) theories support our data. The findings of this study are important for the management of orbital and ocular trauma, as well as for the design of protective devices against such injuries.
This PDF is available to Subscribers Only