Prevalence of Intraocular Injuries in Patients with Orbital Blow-Out Fractures

Purpose: To determine the prevalence of intraocular injuries in patients with blow-out fracture and also to evaluate the etiologic mechanism of orbital blow-out fractures Methods: This study is a consecutive case series analysis of 116 patients with orbital blow-out fractures. The patients were visited by an ophthalmologist within 24 hours of trauma. Results: Ninety-one men and twenty-five women with mean age of 29.1±13.9 years were included for this study. Fist trauma and assault (54%) was the most common cause of orbital blow-out fractures. Inferior wall was involved more commonly (49%) than medial wall and combined form. Significant enophthalmos (>2 mm) was present in 26 cases. Orbital reconstruction surgery was performed in 34% of cases. Intraocular injuries were detected in 25% of patients. Hyphema (65%) and commotio retina (39%) were the most frequent detectable intraocular injuries. Intraocular damages were significantly less common in patients with large fractures (synchronous medial and inferior wall fractures or fracture size equal or more than 1/2 of orbital wall) in contrast to small size fractures (p=0.02). Conclusion: Ocular injuries are relatively common in blow out fractures and ophthalmic examination is mandatory. In our study ocular injuries were less frequent in large fractures than small size fractures that may indicate protective role of orbital integrity or other factors caused by fractures.