Orbital Fractures
An orbital fracture is when you break one or more of the bones surrounding your eyeball. These are your orbital bones, or the bones of your eye socket. This bony cavity contains your eyeball, eye muscles, blood vessels, nerves and other structures. Blunt force trauma — when something hits your eye very hard — is the most common cause of an orbital fracture.
Types of orbital fractures
You can fracture any of the bones surrounding your eyeball. A few types of orbital fractures include:
- Blowout fracture: A blowout fracture is the most common type of orbital fracture. This fracture is a break along the floor or thin inner wall of your eye socket. Getting hit in the eye with something like a fist or a baseball most often causes blowout fractures.
- Orbital rim fracture: An orbital rim fracture affects the bony outer edges of your eye socket. This area is made up of very thick bone, so it takes a lot of force to injure this area. Car accidents are the most common cause of orbital rim fractures. If you have an orbital rim fracture, you likely have other facial fractures.
- Orbital floor fracture: An orbital floor fracture is when the bones of the rim of your eye socket push back, causing your orbital floor bones to buckle downward. These fractures affect the nerves and muscles surrounding your eye, preventing it from moving properly. Car accidents and falls often cause orbital floor fractures.
Causes:
Orbital fractures can occur in adults and children. The most frequent causes in adults include assaults (violence) and car accidents. The most common causes in children include car accidents and being hit in the face with a ball. Other causes of orbital fractures include bike accidents, motorcycle accidents, falls and other sports injuries.
Symptoms of Orbital fracture :
Symptoms may include:
- Blurred vision, double vision or decreased vision.
- Swelling under your eye.
- Black, blue or purple bruising around your eye (black eye).
- Blood in the white part of your eye.
- Swelling of your cheek or forehead.
- Numbness.
- Trouble moving your eye in any direction.
- Flattened cheek.
- Sunken eyeballs or bulging eyeballs.
- Nosebleed (epistaxis).
Treatment Options For Orbital Fractures:
The treatment for an orbital fracture will depend on the severity and location of the fracture, as well as the presence of any associated injuries. Some common treatment options include:
- Observation and Pain Management: In some cases, small or non-displaced orbital fractures may not require surgery and can be managed with rest, ice, pain medication, and close observation.
- Antibiotics: Antibiotics may be prescribed to prevent infection if there is a break in the skin or if the fracture is associated with a laceration or open wound.
- Eye Drops or Ointments: Eye drops or ointments may be prescribed to prevent infection, reduce inflammation, and lubricate the eye.
- Pain Management: Pain medication may be prescribed to manage discomfort and pain associated with the fracture.
- Follow-up Care: Follow-up care with a healthcare professional is important to ensure proper healing and to monitor for any potential complications.
- Surgery: Surgery may be necessary for severe orbital fractures to realign the bones and restore the normal shape and function of the eye socket. Depending on the location and extent of damage, different surgical approaches may be used, including the use of implants or plates to stabilize the bones.
Surgical Treatment for Orbital Fracture
The surgical repair for orbital wall fractures aims to realign the fractured bones, restore orbital volume and protect the eye. Techniques may include:
- Reconstruction with Implants: Here, specialised implants are used to reconstruct and stabilize the fractured orbital walls
- Open Reduction With Internal Fixation: This involves surgically exposing the fracture and realigning the bones using small plates and screws.
- Endoscopic Repair: This involves making small incisions and using an endoscope to visualize and repair the fracture.
- Orbital Floor Reconstruction: This involves reconstructing the floor of the orbit using bone grafts or synthetic materials.
- Canthoplasty or Canthopexy: These procedures involve repositioning or tightening the outer corner of the eyelid to improve eyelid function and alignment.
- Enucleation or Evisceration: These are procedures in which the eye is removed or the contents of the eye are removed and replaced with an implant.
- Follow-up Care: After surgery, close follow-up with a healthcare professional is important to monitor for any complications and ensure proper healing.
Going to home after Orbital wall fracture Surgery
A recovery period is necessary after the repair, where specifi instructions by your surgeon needs to be followed including post operative care , wound care and pain management. Follow –up appointments are crucial to monitor the healing process and access any complications.
