OCULAR INJURIES IN MAXILLOFACIAL TRAUMA

An orbital fracture is when there is a break in one of the bones surrounding the eyeball (called the orbit, or eye socket). Usually this kind of injury is caused by blunt force trauma, when something hits the eye very hard.Orbital fractures are common facial injuries . They usually occur in the context of zygomatic-orbital fractures, as pure blow-out fractures or as a part of panfacial injuries. Patients with significant eye injuries may present with grossly normal eyes and good visual acuity; however, subsequent ocular disorders may become apparent. . Injuries of the orbit are frequently combined with impaired vision (double images) due to reduced eye motility caused by hematoma, ischemia of the eye muscles, and entrapment of orbital soft tissue as well as nerve injuries. Symptoms of an orbital fracture will depend on what kind of fracture it is and how severe the injury is. Symptoms can include:blurry, decreased or double vision (diplopia),black and blue bruising around the eyes(circumorbital ecchymosis) swelling of the forehead or cheek swollen skin under the eye(circumorbital edema), numbness in the injured side (parasthesia ) blood in the white part of the eye (subconjuctival hemorrhage).difficulty moving the eye to look left, right, up or down (opthalmoplegia,)flattened cheek intense(fracture of malar prominence), cheek pain when opening the mouth bulging or sunken eyeballs. clinicaly the patient with a orbitozygomatic fracture will present with step deformity in the infra orbital rim, infra orbital nerve parasthesia , subcute emphysema,along with above mentioned features. Radiographic evaluation helps in identification of type and extend of fracture and to correlate with the clinical features for further management.