• J Coll Physicians Surg Pak · Sep 2014

    Observational Study

    Ophthalmic injuries in orbito-zygomatic fractures.

    • Nabeela Riaz, Asad Aizaz Chatha, Riaz Ahmad Warraich, Saba Hanif, Kashif Ali Chinar, and Shammas Raza Khan.
    • Department of Oral and Maxillofacial Surgery, KEMU / Mayo Hospital, Lahore.
    • J Coll Physicians Surg Pak. 2014 Sep 1; 24 (9): 649-52.

    ObjectiveTo assess the frequency and severity of ophthalmic injuries in patients with orbito-zygomatic fractures.Study DesignA case series.Place And Duration Of StudyOral and Maxillofacial Department, KEMU/Mayo Hospital Lahore, from January 2009 to December 2011.MethodologyPatients with orbito-zygomatic fractures were divided into three groups. Group-1 patients had fracture of floor/medial wall of the orbit (orbital-blow out fracture). Group-2 had comminuted orbito-zygomatic fractures. Group-3 had simple zygomatic bone fractures. Frequency and types of ocular injuries were determined on each group.ResultsThere were 296 (260 male, 36 female) patients with mean age of 31.7 years. Group-1 (n = 20) had 28 ocular findings in 12 (60%) patients including diplopia (n = 10, 36%), enophthalmos (n = 6, 14%), and hyphema, vitreous hemorrhage, retinal hemorrhage, choroidal rupture, traumatic mydriasis, and commotio retinae in 2 cases, 7% each. In Group-2 (n = 106), 44 ocular findings were identified in 30 (28%) patients including diplopia (n = 10, 23%), enophthalmos (n = 4, 9%), commotio retinae (n = 10, 23%), reduced visual acuity (n = 6, 14%), retinal hemorrhage (n = 4, 9%) and corneal laceration, corneal abrasion, retinal detachment, traumatic mydriasis, and canthal laceration in 2 cases, 4.5%. In Group-3 (n = 170), 22 ocular findings were seen in 16 (9%) patients included diplopia (n = 10, 45%), enophthalmos (n = 4, 18%), and retinal tear, hyphema, angle recession, and traumatic mydriasis in 2 cases, (9%) each.ConclusionOphthalmic injuries are a common complication of orbitozygomatic fractures occurring in about 20% of patients in this study, most frequent in the orbital blow fractures subgroup. Ophthalmology consultation is recommended for patients presenting with midface fractures.

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