Abstract
Purpose :
To estimate the most significant risk factors on presentation of a patient with orbital fracture to a Level 1 trauma center that may be associated with urgent ophthalmologic intervention.
Methods :
This is a retrospective case-control study through chart review of 294 cases of orbital fracture over a 2-year period at a Level I trauma center. All consultations which included orbital fractures were included. The primary outcome was urgent ophthalmologic intervention (including globe rupture repair, canthotomy/cantholysis for retrobulbar hemorrhage, etc.). The secondary outcome was semi-urgent ophthalmologic intervention (including treatment of traumatic uveitis, corneal abrasions, lid repairs, etc.). The age and gender of the patient, time to consultation, mechanism of injury, anticoagulant and antiplatelet use, findings on radiographic imaging, and ocular findings at initial and follow-up exam were recorded and odds ratios with 95% confidence intervals were calculated.
Results :
In total, 294 orbital fractures were included in the study. Preliminary data shows that of roughly one third of fractures for which data has been collected, there was no urgent ophthalmological intervention performed.
When data collection and analysis is complete, we expect to report the factors most associated with urgent ophthalmologic intervention in patients presenting to a Level 1 trauma center with orbital fracture and their respective odds ratios. We will also report on factors associated with semi-urgent intervention.
Conclusions :
The results of this study so far indicate that urgent ophthalmologic intervention is rare in orbital fractures (likely less than 1% of cases) as none were found in ~90 cases for which data has been collected. The results of this study will hopefully serve as a starting point for future prospective studies aiming to help guide the most appropriate timeline for ophthalmology consultation in cases of orbital fractures. Our results will also help identify important factors on patient presentation that will prompt first responders to seek urgent ophthalmologic consultation.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.