Orbital Fractures

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The term “orbital fracture” refers to a break in one or more of the bony walls of the eye socket. This injury most commonly occurs after trauma such as a fall or an accident. There are different types of orbital fractures, and each requires different treatment. More than one wall of the orbit may be involved if the injury was extensive.

How Orbital Fractures Are Diagnosed

Broken bones of the orbit are diagnosed by a special kind of X-ray known as a CT scan. CT scans are widely available at all major hospitals and most outpatient imaging centers. The doctor who first evaluates you after you sustain a facial injury will likely order the CT scan test.

Treatment for Orbital Fractures

While some orbital fractures require surgical repair, others will heal if left alone. Patients who have double vision or severe pain with eye movement after sustaining a facial injury should seek medical care immediately, as they may have a fracture that requires urgent repair. In the setting of an orbital fracture, it is not uncommon to experience numbness of the lower eyelid, cheek, side of the nose and upper teeth on the injured side.

When Surgery Is Necessary

The situations in which surgical repair of an orbital fracture is recommended include:

  • Fracture of the orbital rim, the strong bony edge of the eye socket
  • Catching (entrapment) of the muscle or fat surrounding the eye in the gap created by the broken bones with associated double vision
  • Displacement of a large portion of the bony orbital walls
  • Displacement of the outside wall of the orbit

Surgical repair of orbital fractures is usually performed on an outpatient basis, meaning that an overnight hospital stay is generally not required. Incisions are usually hidden inside the lower eyelid or in a natural “smile” line, thus minimizing scarring. The breaks are repaired by realigning the bones, returning displaced muscles or fat to the proper position and placing specially customized plastic or metal plates to hold important structures in their proper position. Most patients experience only mild discomfort after repair of an orbital fracture and choose to take a week or so off from their usual activities to recover.