An orbital fracture is a serious break or crack in one or more of the bones of the eye socket. It can be caused by a motor vehicle accident, fall, sports injury, industrial accident or the like, and be serious enough to affect sight. Depending on whether the eyelid muscles are injured, an orbital fracture can cause double vision. Considerable swelling in the eye area typically accompanies this type of injury. Once swelling recedes, the eye may appear recessed more than is normal. It is often for both cosmetic and functional reasons that surgical treatment of an orbital fracture is necessary.
Assessing an Orbital Fracture
After an injury to the eye area, a thorough physical examination of the eye and its surrounding structures is necessary. In many cases, antibiotics are prescribed to prevent infection, and anti-inflammatory medications are prescribed to promote a rapid reduction in swelling. Imaging tests such as X-rays, MRI scans or CT scans may be performed to determine the precise location of the injury and its severity.
Treatment of orbital fractures may begin with observation only, or surgery may immediately be deemed necessary. The type of treatment is determined by various factors, including location and severity of the fracture, as well as the age and health of the patient. If surgery is needed, incisions are usually small, and placed either inside the eyelid or in creases in the skin so that the resulting scar is hidden.
Surgery is often the most effective way to repair an orbital fracture; it ensure complete healing and lessens the chance of lingering vision problems. There are certain situations in which immediate surgical repair is required; in others, it may be safe to wait a few weeks for inflammation to subside before surgery takes place.
Orbital Fracture Repair
Orbital fracture repair is typically performed with the patient under general anesthesia. An incision is made in the eyelid, or the conjunctiva, the tissue that lines the inner eyelid. Once the fracture is visible to the surgeon, any shards of broken bone are removed, and muscles and tissue are repositioned as necessary.
The damage to the bones is then assessed; if needed, an implant is used to provide support and repair the fracture. Depending on the fracture's characteristics, the implant may consist of the patient's own bone, donor bone, mesh, a synthetic substance or titanium. After the implant has been securely attached, the incision is closed.
Recovery from Orbital Fracture Repair
Post-surgery, the patient is monitored before being released. In some cases, the patient is required to remain in the hospital for one night following the repair. Antibiotics, anti-inflammatory medications, eye drops and/or ointments are prescribed. Most patients experience some pain at the surgical site; pain medications may be taken as necessary to help manage the discomfort. The eye area may be sensitive for several weeks, and placing pressure on the bones as they heal must be avoided.
Complications of Orbital Fracture Repair
Although orbital fracture surgery is often necessary in cases of severe trauma to the eye socket, it does have certain risks, which include incorrect positioning of the globe; recurring double vision; sinus infection; and optic-nerve injury that can result in the blindness.