Orbital Wall Fractures and Ocular Injury: Impact on Management

Area of Science:

• Ophthalmology
• Trauma Surgery
• Oculoplastics

Background:

• Orbital wall fractures frequently accompany ocular injuries.
• Prompt ophthalmology evaluation is crucial for detecting and managing these associated injuries.

Purpose of the Study:

• To determine the impact of ophthalmology consultations on ocular management in patients with orbital wall fractures.
• To identify predictors for changes in ocular management following specialist evaluation.

Main Methods:

• Retrospective cohort study of adult patients (≥18 years) with orbital wall fractures.
• Data collected from 2012-2020 at a Level 1 trauma center, focusing on prompt ophthalmology evaluations.
• Analysis of factors influencing changes in ocular management.

Main Results:

• 27% of patients experienced a change in ocular management post-ophthalmology consultation.
• Moderate to severe ocular injuries were present in 50% of cases.
• Eyelid laceration, extra-ocular motion (EOM) abnormality, and pupillary defects were associated with increased likelihood of management change.
• No delays in surgical management of the bony fractures were observed.

Conclusions:

• Ophthalmology consultation significantly alters ocular management in a notable percentage of patients with orbital wall fractures.
• Specific clinical findings like eyelid laceration, EOM abnormalities, and pupillary defects are key indicators for potential management shifts.
• Specialist evaluation ensures appropriate ocular care without compromising timely surgical intervention for the fracture itself.