Strabismus in pediatric orbital wall fractures

Area of Science:

• Ophthalmology
• Pediatric Surgery
• Trauma Surgery

Background:

• Orbital wall fractures are common in children following trauma.
• Strabismus can be a significant complication, impacting visual development and binocular function.
• Understanding the specific clinical profiles and outcomes is crucial for effective management.

Purpose of the Study:

• To evaluate the clinical characteristics and outcomes of strabismus in pediatric patients who sustained orbital wall fractures.
• To identify factors associated with the development and persistence of strabismus after orbital trauma.

Main Methods:

• A retrospective interventional study was conducted on pediatric patients (age ≤16 years) with traumatic orbital wall fractures.
• Data collected included patient demographics, fracture details, surgical interventions, and strabismus assessment.
• Clinical outcomes and the need for further strabismus surgery were analyzed.

Main Results:

• Forty-three children with orbital fractures were studied; 27.90% developed manifest strabismus, predominantly exotropia.
• The majority of strabismus cases (91.66%) were restrictive, resulting from muscle entrapment or local trauma.
• Surgical repair of orbital fractures led to improved ocular motility in most patients; four required subsequent strabismus surgery.

Conclusions:

• Strabismus is a frequent complication of pediatric orbital wall fractures, often presenting as a restrictive type.
• While orbital fracture repair generally improves ocular alignment and motility, persistent or severe cases may necessitate dedicated strabismus surgery.
• The characteristics of pediatric orbital fractures, particularly trapdoor fractures, and the timing of repair influence outcomes.