A Study of Orbital Fractures

Aim: To study the etiology, the types of orbital fractures, their clinical presentation, management strategies, outcomes, and prognosis. Materials and Methods:This prospective observational study was conducted on 17 patients with orbital fractures who presented to the Department of Ophthalmology of a government medical college in Visakhapatnam, Andhra Pradesh.The evaluation consisted of a detailed history, visual acuity, color vision, ocular motility, forced duction test (FDT), diplopia charting, Hertel's exophthalmometry, and a detailed anterior and posterior segment examination.All patients underwent a plain computerized tomography (CT) scan of the orbit.Patients with traumatic optic neuropathy received intravenous (IV) Methylprednisolone as soon as diagnosis while those who needed surgery were referred to a center having multidisciplinary specialists.Others were treated conservatively.Results: Most of the cases were males, with the major cause being road traffic accidents (RTA) followed by industrial accidents.Single wall fracture was the most common type and the rest were complex combined fractures.Nearly a third of the patients presented with diplopia, relative afferent pupillary defect (RAPD), and enophthalmos.While nearly half of the presenting cases improved with IV methylprednisolone, the rest required surgical management.Significant improvement in vision, color vision, and ocular motility was noticed in either management strategy.Poor prognosis was noticed in those who presented with a perception of light (PL) at the first visit.Conclusions: Good results in orbital fractures are often provided by timely intervention and the visual prognosis depends on initial visual acuity at presentation.