From the Guidelines
An orbital fracture is a serious condition that requires prompt medical attention, and treatment options depend on the severity and location of the fracture, with surgical repair necessary for fractures causing persistent double vision, significant eye displacement, or large defects, and conservative management recommended for minor fractures without functional problems, as stated in the most recent study 1.
Symptoms of Orbital Fracture
The symptoms of an orbital fracture include:
- Pain
- Swelling
- Double vision
- Numbness around the eye
- Sunken appearance of the eye These symptoms can vary depending on the severity and location of the fracture, and a thorough examination is necessary to determine the best course of treatment, as outlined in the study 1.
Treatment Options
Treatment options for an orbital fracture depend on the severity and location of the fracture, and may include:
- Conservative management, including ice packs, head elevation, nasal decongestants, and pain control with acetaminophen or NSAIDs, as recommended in the study 1
- Antibiotics, such as amoxicillin-clavulanate, to prevent infection, as stated in the study 1
- Surgical repair, which is necessary for fractures causing persistent double vision, significant eye displacement, or large defects, and is usually performed within 2 weeks of injury for optimal outcomes, as outlined in the study 1
- Follow-up with an ophthalmologist to monitor for complications like enophthalmos or persistent diplopia, as recommended in the study 1
Importance of Prompt Medical Attention
Prompt medical attention is necessary to prevent complications and ensure optimal outcomes, as stated in the study 1. Delayed treatment can lead to permanent damage, including enophthalmos, telecanthus, lacrimal obstruction, and ptosis, as outlined in the study 1. Therefore, it is essential to seek medical attention immediately if symptoms of an orbital fracture occur.
Key Considerations
Key considerations in the treatment of orbital fractures include:
- The severity and location of the fracture
- The presence of symptoms, such as double vision or numbness around the eye
- The need for prompt medical attention to prevent complications
- The importance of follow-up with an ophthalmologist to monitor for complications, as recommended in the study 1
- The potential for surgical repair, and the timing of such repair, as outlined in the study 1
From the Research
Symptoms of Orbital Fractures
- Enophthalmos (sunken eye) and/or diplopia (double vision) from extraocular muscle entrapment 2
- Traumatic optic neuropathy, ptosis (drooping eyelid), perforating eye injuries, intraorbital foreign bodies, and oculomotor nerve palsy can occur in association with orbital roof fractures 3
Treatment Options for Orbital Fractures
- Alloplastic implant placement with careful release of periorbital fat and extraocular muscles can effectively restore extraocular movements, orbital integrity, and anatomic volume 2
- Surgical intervention may be required for ophthalmic sequelae such as motility problems, lagophthalmos (inability to close the eye), and retained intraorbital foreign bodies with cerebrospinal fluid leaks 3
- Conservative management is possible for some patients, with a multidisciplinary approach to management required due to common facial and cerebral injuries 3
- Antibiotic prophylaxis may be used to prevent orbital infection, with shorter courses and avoidance of broad-spectrum agents recommended 4
- Early recognition and treatment of blowout fractures, including intravenous antibiotic and corticosteroid administration, multidisciplinary treatment, and early recognition of candidates for emergency and early surgical treatment, can reduce the rate of complications 5
Postoperative Care
- Overnight observation or longer may be necessary due to the risk of rare but devastating complications such as retrobulbar hematoma (RBH) 2
- Selected patients can be managed on an outpatient basis, which can have a positive effect on conservation of diminishing healthcare resources 2
- A majority of surgeons observe postoperative patients overnight, while some may send patients home the same day of surgery 2