Ocular injuries in 367 patients with middle and upper third facial trauma: experience in Tehran

Ocular injuries are commonly associated with facial injuries. I provide a retrospective study of 367 patients who sustained severe major ocular injuries associated with middle and upper third facial injuries. These patients were selected from 1,608 patients who sustained different types of craniomaxillofacial injuries over a 7-year period (1984 to 1990). The characteristics of the ocular injuries sustained were related to the cause of the facial trauma. More than 52.04% of severe ocular injuries were associated with isolated lateral midface injuries, 42.5% were associated with middle-third injuries, and 5.44% were associated with upper third facial injuries. Among all patients 29.97% lost their vision partially or completely. The major causative factor was firearms during the Iraq-Iran war (64.03%) followed by road traffic accidents (40.15%). Sports caused a low incidence of ocular injuries. Ocular injuries were treated by the ophthalmic surgeons in cooperation with the maxillofacial surgeons and the neurosurgeons. There was an increase in the residual complications in facial or ocular injuries resulting primarily from the evacuation system. Although the psychological problems related to the ocular injuries and residual periorbital deformities were great, patients' spirituality and their beliefs gave them much patience and hope in facing these difficulties and complications. A close relationship among ophthalmic surgeons, neurosurgeons, and maxillofacial surgeons is very important to decrease the incidence of complications involving ocular injuries after craniomaxillofacial injuries.