Orbital and optic nerve trauma

The ability to measure orbital volume expansion and correlate this with later enophthalmos has advanced radiological assessment of patients with orbital floor fractures. Attempts have also been made to classify orbital floor fractures on the basis of their configuration on CT scan and to correlate this with outcome in terms of ocular motility. A small subset of relatively undisplaced floor fractures with tight entrapment of tissues occurring most commonly in young patients has been identified, and early surgical intervention has been recommended for these. The range of alloplastic materials available for orbital rim and wall fractures has increased, and complications related to various alloplastic implants continue to be reported. Optic nerve trauma has received considerable attention but remains a difficult management area. Recent literature on this subject shows no definite benefit for optic nerve decompression or high dose corticosteroids, although no prospective randomized study has been possible.