IP International Journal of Ocular Oncology and Oculoplasty


Etiology and pattern of orbital fractures in a teaching hospital


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Author Details: Rajendra P. Maurya, Pradeep Jain, Virendra Pratap Singh, Mahendra Kumar Singh, C.P. Mishra, Aashish

Volume : 3

Issue : 3

Online ISSN : 2581-5016

Print ISSN : 2581-5024

Article First Page : 184

Article End Page : 192


Abstract

Purpose: To explore the etiological factors and pattern of orbital injuries in patients of trauma.
Materials and Method: A prospective case series of 176 patients of orbital trauma diagnosed by computerized tomography. All patients were evaluated for demographic and injury profile. After thorough clinical examination, injury and fracture pattern were analyzed by using multi-slice CT Scan, utilizing three- dimensional visualization of computed tomography images.
Results: Hundred eighty two eyes of 176 patients were evaluated. There were 81.82% male and 18.18% females. 61.36% victims were between 16-45 years of age. Majority of victims belonged to rural background (73.86%) and student (34.60%) by occupation. Based on the etiology, road traffic accident (37.50%) were most common, followed by assault (22.16%), sport related injuries (15.90%) and fall/ domestic accidents (10.23%). Orbital fractures associated with craniofacial fracture (51.71%) were more common than isolated orbital fractures (18.75%). Most common mode of injury was collision/ impact (48.86%). Majority of patients had unilateral orbital fracture (96.60%); 59.66% sustained left sided injury. Most of the eyes (51.95% right eye & 27.62% left eye) had single orbital wall fracture and pan orbital wall fracture was more commonly observed in right eye injury (5.20%). Among the right eye injury, most common orbital wall fracture was floor fracture (64.93%) while in left eye injury most common was roof fracture (56.19%). Most common type of fracture was linear/ minimally displaced break (48.86%) while multiple comminuted severely displaced fracture was observed in 40.91% cases. At the time of presentation visual impairment (visual acuity 6/18 – 6/60) was observed in 23 right eye and 40 left eye and blindness (< 6/60 – NO PL) was seen in 32 eyes (right & left both).
Conclusion: Orbital injuries are commonly caused by road traffic accidents. Orbital injuries are more likely to occur in young adult male, and be associated with craniofacial injuries. Because of complex nature of craniofacial fractures, which may be comminuted, involving multiple bone and or associated with soft tissue edema / neurologic injuries. Management of such orbital injuries are more challenging and require a multidisciplinary approach.

Keyword
: Ecchymosis, Emphysema, Maxillofacial trauma, Orbital wall fracture, Road traffic accidents, Assault