Abstract
Purpose :
Orbital fractures are a common ophthalmological referral and are frequently associated with intraocular and other non-ocular injury.
We performed a retrospective, observational study to investigate the presentation, epidemiology, management, and outcomes of orbital fractures at a high-volume trauma centre.
Methods :
Consecutive orbital fractures presenting to a major trauma centre in Melbourne, Australia between 1 July 2012 and 30 June 2015 were reviewed. Patients were included if they had at least one orbital fracture confirmed radiologically. Clinical findings from the initial review and final review were recorded. Multiple logistic regression was used for statistical analysis of associations between outcomes and variables.
Results :
500 orbits of 413 patients had at least one fracture. Males were over-represented (74%). Falls were the most common mechanism (34%), followed by motor vehicle accidents (24%). Significant intraocular injuries were noted in 76 cases (15%), including 15 globe ruptures (3%). Intraocular injury was associated with findings of proptosis (OR 3.1, 95% CI 1.6-6.0) and rectus entrapment (OR 6.5, 95% CI 1.4-29.5). Concommitant neurological injury was present in 39%. Neurological injury was associated with roof fracture (OR 3.7, 95% CI 2.2-6.1) and bilateral orbital fractures (OR 1.8, 95% CI 1.1-2.8). 31% of orbits underwent surgical reconstruction in our series. At initial review, significant diplopia was noted in 14% and a visual acuity (VA) of <6/60 was noted in 5%. At final review, 6% had significant diplopia and 5% had a VA of <6/60.
Conclusions :
Orbital fractures were associated with significant ocular and neurological injury in this series. The rate of injury from falls is higher in our setting than reported in the literature. Despite the significant rate of associated ocular injury, visual prognosis is reasonable with low rates of significant diplopia and severe visual loss at final follow-up.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.