Incidence of diplopia associated with pure orbital blowout fracture: A narrative review

Key Points

• This review aims to assess the incidence of diplopia following pure orbital blowout fractures and the impact of surgical timing on outcomes.
• Conducted structured searches from 2012 to 2025 across multiple databases.
• Included studies with CT-confirmed pure blowout fractures and documented diplopia outcomes.
• Focused on fractures with a follow-up of at least three months.
• Initial diplopia incidence ranges from 21% to 75%, influenced by fracture complexity.
• Larger defects and muscle entrapment are strong predictors of diplopia, with an odds ratio of 19.8.
• Early surgery, within 4.5 to 14 days, is associated with better resolution of diplopia.
• Long-term persistent diplopia is rare.

Abstract