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Management of White-Eyed Blowout Fracture in the Pediatric Population
Kannan Balaraman1, J Sai Santosh Patnaik1, Vimalambiga Ramani1
1Department of Plastic Surgery, Hand Surgery, Reconstructive Microsurgery, Facio Maxillary Surgery, Aesthetic Surgery, Oncoplastic Breast Surgery and Burns, Ganga Hospital, Coimbatore, India.
Insights
Prompt diagnosis and management of white-eyed orbital blowout fractures in children are crucial for complete recovery. Delayed intervention can lead to persistent diplopia and limited eye movement.
Area of Science:
- Ophthalmology
- Pediatric Trauma
- Orbital Fractures
Background:
- Diplopia in children is rare but can indicate serious injury.
- White-eyed orbital blowout fractures present with restricted upward eye movement, requiring timely intervention.
Purpose of the Study:
- To evaluate the timing of surgical intervention and functional outcomes in pediatric patients with white-eyed orbital blowout fractures.
Main Methods:
- Retrospective analysis of 4 pediatric cases with white-eyed orbital blowout fractures at a tertiary trauma center.
- Data collected included age, injury mechanism, gaze limitation, intervention timing, and pre/post-operative diplopia.
- Minimum follow-up of 1 year.
Main Results:
- All injuries were sports-related.
- Three out of four patients achieved full recovery of diplopia and eye movements.
- One patient with delayed treatment experienced persistent symptoms.
Conclusions:
- White-eyed orbital blowout fractures in children necessitate prompt diagnosis and management for optimal outcomes.
- Misdiagnosis as head injury can delay treatment and impair recovery.
Aims And Objectives:
Diplopia in children is uncommon. However a small group of patients present with diplopia and severe restriction of upward globe movement which requires early diagnosis and prompt intervention. This study aims to evaluate the timing of intervention and functional outcome in the management of white-eyed blowout fractures.
Methodology:
The study was conducted in a tertiary level trauma center. There were a total of 46 orbital floor injuries over a period of 2 years out of which 4 patients with white-eyed blowout fractures were identified. Details of each case were entered on a standard data base and analysed with respect to age, mode of injury, extent of limitation of gaze, timing of intervention, pre and post-operative diplopia. Minimum follow up period for every case was 1year.
Results:
All of them had sports related injuries. Three of the four patients had complete recovery from diplopia with full range of eye movements. However one child with delayed presentation didn't recover fully and had persistence of symptoms within the functional range.
Conclusion:
White-eyed orbital blowout fracture in kids though uncommon need prompt diagnosis and management for complete recovery. The initial clinical presentation mimics that of head injury and hence can be missed, leading to a delay in diagnosis resulting in incomplete recovery.
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