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Orbital Fractures
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Orbital Fractures

Last Updated on May 15, 2019
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What are Orbital Fractures?

An orbital fracture is a break in one or more of the bones surrounding the eyeball, known as the orbit or eye socket. This kind of injury usually occurs due to blunt force that hits the eye, causing trauma.

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Orbital fractures are not always isolated injuries, but can be associated with other non-orbital injuries such as maxillofacial, neck, spine, and head fractures.

Orbital Fractures: Facts & Figures

  • 48 percent of orbital fractures are orbital floor fractures (most common)
  • 25.2 percent of orbital fractures are medial wall fractures (second most common)
  • 29 percent cases of orbital fractures are associated with other ocular injuries
  • 0.7-10 percent of patients become blind as a result of orbital fractures
  • 50 percent of patients having orbital fractures also sustain visceral injuries
  • Most orbital fractures occur in males in their second decade of life
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Anatomy of the Orbit

The orbit or eye socket is one of a pair of bony ‘cup-shaped’ cavities that houses the eyeball and other structures of the eye. It is formed by the following 7 bones: (1) Zygomatic, (2) Sphenoid, (3) Maxillary, (4) Frontal, (5) Lacrimal, (6) Palatine, and (7) Ethmoid. The orbital contents include the eye, muscles, ligaments, fascia, five cranial nerves, blood vessels, lacrimal or tear glands, and associated structures.

What are the Types of Orbital Fracture?

Orbital fractures are of the following three types:

  • Orbital Rim Fracture: This type of fracture affects the thick bony outer edges of the orbit, which requires a lot of force to break. Orbital rim fractures are most commonly caused by car accidents and are often associated with other injuries, including damage to the optic nerve.
  • Blowout Fracture: Here, the thin bone of the floor and inner wall of the orbit are fractured. The crack can entrap the ocular muscles, preventing eye movement. A blowout fracture can be caused by a punch in the eye or being hit by a cricket ball or baseball. Around 33 percent of blowout fractures are associated with ocular trauma.
  • Orbital Floor Fracture: This type of fracture is caused by a blow to the rim, which pushes the bones backwards, causing buckling of the bones of the orbital floor. Orbital floor fractures are commonly caused by falls, especially in elderly people.

References:

  1. Joseph JM, Glavas IP. Orbital Fractures: A Review. Clin Ophthalmol. 2011; 5: 95-100 - (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3037036/)
  2. Boyette JR, Pemberton JD, Bonilla-Velez J. Management of Orbital Fractures: Challenges and Solutions. Clin Ophthalmol. 2015; 9: 2127-37 - (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4655944/)
  3. Chiang E, Saadat LV, Spitz JA, Bryar PJ, Chambers CB. Etiology of Orbital Fractures at a Level I Trauma Center in a Large Metropolitan City. Taiwan J Ophthalmol. 2016; 6(1): 26-31. - (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5602121/)
  4. Orbital Fracture - WikEM - (https://wikem.org/wiki/Orbital_fracture)
  5. Orbital Fractures: Patient Factsheet - Agency for Clinical Innovation (ACI), Government of New South Wales (NSW), Australia - (https://www.aci.health.nsw.gov.au/__data/assets/pdf_file/0003/319674/orbital-fractures-ed-patient-factsheet-april-2016.pdf)
  6. What is an Orbital Fracture? - American Academy of Ophthalmology - (https://www.aao.org/eye-health/diseases/what-is-orbital-fracture)
  7. Orbital Fractures - Temple Health, Philadelphia, USA - (https://www.templehealth.org/services/conditions/orbital-fractures)

Latest Publications and Research on Orbital Fractures

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