Blindness and severe visual impairment in facial fractures: an 11 year review

We present an 11 year review of facial fractures treated in the Australian Craniofacial Unit and the Department of Plastic and Reconstructive Surgery at the Royal Adelaide Hospital, specifically looking at those fractures in adults that resulted in blindness or severe visual impairment. During the period 1989-2000, a total of 2516 patients with facial fractures were treated operatively. From our facial-fracture database, 317 patients were identified as having an ophthalmological complication on presentation. Of these, 19 had severe visual impairment or blindness. The exact fracture pattern and craniofacial disruption score were recorded for each of these 19 cases using the Cooter-David facial-fracture scoring system. Laterally directed forces are implied as major causative factors in these injuries. Recommendations are made based on these findings.