Orbital Fracture

Blog by Ivan J. Srut, O.D.

Chief Of Optometry For St. Hope Foundation

This month’s topic is one that hits a little closer to home than those in past blogs since my wife recently suffered an injury to her left eye and has multiple orbital fractures. 

An orbital fracture is a fracture of any of the bones that surround the eye, or orbit. This type of fracture is typically caused by blunt force trauma, meaning something hit the eye very hard, or the eye hit something very hard! Any of the bones around the eye can be fractured, and the fractures are classified in a few categories. 

BLOW OUT FRACTURE

A blow out fracture is a fracture of the floor or inner wall of the eye socket, which are thinner bones. It can cause eye muscles and other eye structures getting caught in the cracks of the bone, and can keep the eye muscles from moving properly, or being trapped. Getting hit by a fist or baseball is a common cause of this type of fracture. 

ORBITAL RIM FRACTURE

An orbital rim fracture is one that occurs in the outer thicker bones of the orbit and requires much more force since the bones are thicker. This is typically caused by a car accident. 

ORBITAL FLOOR FRACTURE

An orbital floor fracture is when the trauma that happens to the orbital rim causes the bones to be pushed back and can cause the floor of the orbit to buckle. This can also trap muscles of the eye keeping the eye from moving or moving properly. 

Fortunately, in my wife’s case, her fractures are more orbital rim fractures. However, they are not wide enough for any of her eye muscles to be trapped to restrict her eye movement. She was very lucky! She has been examined by a facial surgeon, and a buddy of mine that is an excellent oculoplastic ophthalmologist (an ophthalmologist that specializes in plastic surgery of the eye), and they are both confident that her bones will fuse back together over time and that surgery will not be necessary. 

Here are some symptoms of orbital fractures:

● blurry, decreased or double vision

● black and blue bruising around the eyes

● swelling of the forehead or cheek 

● swollen skin under the eye

● numbness in the injured side of the face

● Blood in the white part of the eye

● difficulty moving the eye to look left, right, up, o rdown

● flattened cheek

● intense cheek pain when opening the mouth

● bulging or sunken eyeballs 

Orbital fractures often don’t need treatment, but need icing to decrease swelling, sometimes antibiotics to prevent infection, and observation. Heat is typically added once the swelling is gone to speed the healing process. If surgery is needed to get the bones in proper position or alignment the oculoplastic ophthalmologist is typically the one to perform the surgery with possible help from a facial surgeon. 

If you suffer trauma to the eye make sure you see an eye doctor! If a surgeon or specialist needs to be brought in that will be decided by the eye doctor after a thorough examination! 

Until next time… 

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