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Diplopia following midfacial fractures.

I A al-Qurainy1, L F Stassen, G N Dutton

  • 1Tennent Institute of Ophthalmology, Western Infirmary, Glasgow.

The British Journal of Oral & Maxillofacial Surgery
|October 1, 1991
PubMed
Summary

Diplopia, or double vision, affects nearly 20% of patients with midfacial fractures. Most cases resolve within six months, with few requiring surgery, highlighting the importance of early fracture repair.

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Area of Science:

  • Ophthalmology
  • Trauma Surgery
  • Facial Reconstruction

Background:

  • Midfacial fractures are common injuries resulting from blunt trauma.
  • Diplopia is a significant complication impacting patient quality of life.
  • Understanding risk factors and outcomes is crucial for effective management.

Purpose of the Study:

  • To investigate the incidence and risk factors of diplopia following midfacial fractures.
  • To evaluate the recovery rate and long-term outcomes of diplopia in these patients.
  • To assess the impact of early surgical intervention on diplopia.

Main Methods:

  • A prospective study of 363 patients with 438 midfacial fractures over 2 years.
  • All patients underwent ophthalmological examination within one week of injury.

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  • Data collected included fracture type, cause, and development and resolution of diplopia.

    • Main Results:

    • Diplopia occurred in 19.8% of patients, most frequently after road traffic accidents (31%) and least after falls (10%).
    • Blow-out fractures were associated with a 58% incidence of diplopia.
    • 82% of patients recovered from diplopia within 6 months; only one required squint surgery.

    Conclusions:

    • Road traffic accidents, blow-out fractures, and comminuted malar fractures are key risk factors for diplopia.
    • Early surgical reconstruction of midfacial fractures, coupled with conservative management of motility disorders, minimizes long-term diplopia.
    • Prompt ophthalmological assessment and timely intervention are vital for managing diplopia after midfacial trauma.