The bones which make up the face are intricate, help define our appearance, shape faces, and help protect vulnerable, essential parts of the body, such as the eyes. In the a orbital blow-out fracture, trauma to the eye and orbit may cause either the side walls or the floor of the orbit to become fractured, with entrapment of orbital contents. Motor vehicle accidents, blunt orbital trauma or other facial trauma can cause a fracture of the orbital bones. This type of injury occurs from occasionally in sports after contact with hard objects such as a baseball, hockey puck, a ball, or a stick. Orbital blow-out fractures can also occur as a result of other traumas. The floor of the orbit fractures most often. Radiographic as well as clinical evidence determines the diagnosis of a blow-out fracture. Ocular injury must also be ruled out in an eye exam.
Signs of a blowout fracture may vary, but will commonly include one or all of the following symptoms or signs: double vision, pain on up gaze or side gaze; swollen eyelids; loss of feeling over upper cheek area; bleeding underneath the conjunctiva (subconjunctival hemorrhage); escape of blood cells into tissues from ruptured blood vessels around the eye socket (periorbital ecchymosis); and restricted eye movement.
Surgery is required if the patient experiences double vision when looking straight ahead or to read, or when the eye sinks back deeply in the socket. The need for r surgery is determined after the swelling from the injury goes down generally a week or so after the injury. Surgery is usually performed about two weeks after the injury. Orbital implants may be inserted to help keep the eye in place. Some scarring will occur. There’s a good chance that the surgery will provide a permanent cure. However, sometimes only partial relief from a sunken eye or double vision is obtained.
Fortunately, many blowout fractures heal quickly and without serious consequence when surgery is not required. Steroid pills may be used to reduce swelling and antibiotics may be given to prevent infection.