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Orbital Fractures

The structure that surrounds your eye to protect it and keep it in place are “orbital bones.” If these bones become fractured usually because of a blunt impact there is a chance they can heal on their own but if you were to suffer a more severe injury you may need corrective surgery to reconstruct the eye socket. SightMD offers complete care for these types of injuries – called “orbital fractures.” Our advanced techniques allow us to correct double vision and obstructed eye movement that may result from these injuries.

Different Types of Orbital Fracture

Any of the bones surrounding the eye can be fractured, or broken. Here are types of orbital fractures:

Orbital Rim Fracture

This injury affects the bony outer edges of the eye socket. Because the rim is made up of very thick bone, an injury to this area has to carry a lot of force for a fracture to occur. Car accidents are one of the main causes of this kind of fracture. If someone has an orbital rim fracture, it is likely they have other injuries to the face, and possibly the optic nerve.

Blowout Fracture

A blowout fracture is a break in the floor or inner wall of the orbit or eye socket. A crack in the very thin bone that makes up these walls can pinch muscles and other structures around the eye, keeping the eyeball from moving properly. Getting hit with a baseball or a fist often causes a blowout fracture.

Orbital Floor Fracture

This is when a blow or trauma to the orbital rim pushes the bones back, causing the bones of the eye socket floor buckle to downward. This fracture can also affect the muscles and nerves around the eye, keeping it from moving properly and feeling normal.

internal face view of orbital fracture

What Are Orbital Fracture Symptoms?

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
  • Black And Blue Bruising Around The Eyes
  • Swelling Of The Forehead Or Cheek
  • Swollen Skin Under The Eye
  • Numbness In The Injured Side Of The Face
  • Blood In The White Part Of The Eye
  • Difficulty Moving The Eye To Look Left, Right, Up Or Down
  • Flattened Cheek
  • Intense Cheek Pain When Opening The Mouth
  • Bulging Or Sunken Eyeballs

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.

If you’re experiencing signs or symptoms of an orbital fracture, Contact SightMD today to schedule an appointment with one of our doctors to discuss your Ophthalmic Plastic Surgery options at one of our convenient locations!