Orbital fractures in children
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Updated: Oct 7, 2026
Three-Dimensional Reconstruction of Orbital Fractures
Published on: May 16, 2025
M P Hatton1, L M Watkins, P A Rubin
1Massachusetts Eye and Ear Infirmary, Boston, Massachusetts 02114, USA.
Insights
Pediatric orbital fractures, often caused by sports or accidents, commonly affect the orbital floor and medial wall. Comprehensive ophthalmic evaluation is crucial due to frequent associated ocular injuries.
Area of Science:
- Ophthalmology
- Pediatric Traumatology
- Facial Surgery
Background:
- Orbital fractures are complex injuries requiring specific management in pediatric populations.
- Understanding the unique characteristics of pediatric orbital fractures is essential for optimal patient care.
Purpose of the Study:
- To detail the demographics, causes, clinical features, and outcomes of orbital fractures in children.
- To identify common fracture locations and surgical indications in pediatric orbital trauma.
Main Methods:
- Retrospective case series of 96 pediatric patients (<18 years) with orbital fractures.
- Inclusion of both hospitalized and non-hospitalized patients presenting to a major ophthalmology center.
Main Results:
- Most frequent etiologies included sports injuries, assaults, and motor vehicle accidents.
- Medial wall and orbital floor fractures were most common; surgery was often required for entrapment.
- Half of the patients had associated ocular injuries, highlighting the need for thorough eye examinations.
Conclusions:
- Pediatric orbital fracture patterns (floor and medial wall) resemble those in adults.
- Orbital fractures in children frequently necessitate surgical intervention.
- The high incidence of ocular injuries underscores the critical importance of comprehensive ophthalmic assessment in pediatric orbital trauma.
Purpose:
To describe the demographics, etiologic factors, clinical presentations, and outcomes of orbital fractures in children.
Methods:
This was a retrospective case series of 96 consecutive patients under 18 years of age with orbital fractures presenting to the Massachusetts Eye and Ear Infirmary, including both hospitalized and nonhospitalized patients.
Results:
Orbital fractures in children were most frequently the result of sports, assault, or motor vehicle accident. The majority of patients did not require hospitalization and were treated as outpatients. The medial wall and floor of the orbit were the most frequent locations of fracture. Approximately half of the patients in this series required surgery, most often for entrapment. There were no cases of persistent diplopia in patients in whom surgery was performed or was not indicated. Associated ocular injuries were observed in half of the patients.
Conclusions:
In this series of hospitalized and nonhospitalized patients, orbital fractures in children had a location pattern similar to that most frequently observed in adult patients (floor and medial wall). Orbital fractures in children frequently require surgery. The high prevalence of ocular injury in children with orbital fractures emphasizes the need for a comprehensive ophthalmic evaluation.
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