From the Guidelines
Orbital fractures are primarily managed by ophthalmologists, specifically oculoplastic surgeons, who specialize in reconstructive surgery around the eye. According to the adult strabismus preferred practice pattern 1, strabismus after orbital trauma is common and may be present along with other ophthalmic, medical, and surgical conditions. The management of orbital fractures often requires a multidisciplinary approach involving:
- Maxillofacial surgeons
- Otolaryngologists (ENT specialists)
- Neurosurgeons depending on the complexity and extent of the fracture. Treatment typically begins with a thorough evaluation including CT scans to assess the fracture pattern and determine if surgery is necessary 1. For simple, non-displaced fractures, conservative management may be sufficient, while surgical intervention is generally indicated for fractures causing diplopia (double vision), significant enophthalmos (sunken eye appearance), or muscle entrapment 1. The study highlights the importance of determining the cause of diplopia after orbital trauma, which requires a detailed history, examination, and often imaging 1.
From the Research
Specialty Dealing with Orbital Fractures
The specialty that deals with orbital fractures includes:
- Ophthalmology, as orbital fractures are a common manifestation of facial trauma encountered by ophthalmologists 2, 3
- Oculoplastic surgery, which involves the treatment of injuries of the eyelid, lacrimal system, and orbit, including orbital fractures 4
- Oral and maxillofacial surgery, as orbital floor fractures are also encountered by oral maxillofacial specialists 3, 5
- Otolaryngology, as orbital floor fractures are a common manifestation of facial trauma encountered by otolaryngology specialists 3
Treatment and Management
The treatment and management of orbital fractures may involve:
- Surgical reconstruction, which is often the treatment of choice for oculoplastic traumas, including orbital fractures 4
- Surgical intervention, which is required emergently in cases of tissue entrapment and less urgently in cases of persistent diplopia, enophthalmos, and/or fractures involving a significant portion of the orbital floor 3
- Postoperative care, which may include formal ophthalmology examination, especially for patients with preoperative ocular injuries or multiple facial fractures 5