Review of Ocular Injuries in Patients with Orbital Wall Fractures: A 5-Year Retrospective Analysis

Stephanie B Terrill,1 Hyelin You,2 Heidi Eiseman,1 Michael E Rauser1 1Department of Ophthalmology, Loma Linda University Eye Institute, Loma Linda, CA, USA; 2Department of Ophthalmology, Loma Linda University School of Medicine, Loma Linda, CA, USACorrespondence: Michael E RauserLoma Linda Universit...

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Autores principales:	Terrill SB, You H, Eiseman H, Rauser ME
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	ocular trauma orbital wall fracture subconjunctival hemorrhage globe rupture entrapment vision loss Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/2ae051c359e44f78a1581f9be6f6ac08
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spelling	oai:doaj.org-article:2ae051c359e44f78a1581f9be6f6ac082021-12-02T05:44:11ZReview of Ocular Injuries in Patients with Orbital Wall Fractures: A 5-Year Retrospective Analysis1177-5483https://doaj.org/article/2ae051c359e44f78a1581f9be6f6ac082020-09-01T00:00:00Zhttps://www.dovepress.com/review-of-ocular-injuries-in-patients-with-orbital-wall-fractures-a-5--peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Stephanie B Terrill,1 Hyelin You,2 Heidi Eiseman,1 Michael E Rauser1 1Department of Ophthalmology, Loma Linda University Eye Institute, Loma Linda, CA, USA; 2Department of Ophthalmology, Loma Linda University School of Medicine, Loma Linda, CA, USACorrespondence: Michael E RauserLoma Linda University Eye Institute, 11370 Anderson Street, Suite 1800, Loma Linda, CA 92354, USATel +1 909 558 2112Email mrauser@llu.eduPurpose: The purpose of this study was to determine the incidence of minor and major ocular injuries in patients with orbital wall fractures at Loma Linda University Health, a level-one trauma center, to help determine the most appropriate setting for the initial dilated fundus examination by ophthalmologists.Methods: A retrospective study was performed from January 2008 to January 2013 of patients diagnosed with orbital wall fracture secondary to trauma. Exclusion criteria included unknown mechanism of injury, the absence of ophthalmology consultation, or absence of imaging. Data collected included age, gender, mechanism of injury, visual acuity, and anterior/posterior segment findings. Ocular injuries were categorized as either minor or major.Results: Of 567 charts reviewed, 460 met criteria and were included for analysis. In the analysis, 86.5% of patients were male, and 81.3% were Caucasian. The most common mechanism of orbital fracture was blunt injury. Visual acuity was better than 20/100 in 82.4% of patients. On chart review, 81.1% of patients were found to have either a minor injury, a major injury, or both. The most common injury was subconjunctival hemorrhage (53.5%). Globe rupture (2.9%) and vision-threatening posterior segment findings such as retinal tear and choroidal rupture (1.3%) were relatively rare. Only one retinal detachment (0.2%) was found, specifically in the setting of severe injury with concomitant globe rupture.Conclusion: Knowledge of the common ocular injuries associated with orbital fractures will help emergency department (ED) physicians and ophthalmologists provide the dilated fundus exam in the most appropriate setting. The most frequent injuries identified were non-vision threatening, and visually significant posterior segment findings were relatively rare (1.3%). Thus, for the majority of patients presenting to the ED with orbital fracture, a dilated fundus exam can be performed at a later date in the outpatient clinic setting, unless urgent orbital fracture surgery is planned.Keywords: ocular trauma, orbital wall fracture, subconjunctival hemorrhage, globe rupture, entrapment, vision lossTerrill SBYou HEiseman HRauser MEDove Medical Pressarticleocular traumaorbital wall fracturesubconjunctival hemorrhageglobe ruptureentrapmentvision lossOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 14, Pp 2837-2842 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	ocular trauma orbital wall fracture subconjunctival hemorrhage globe rupture entrapment vision loss Ophthalmology RE1-994
spellingShingle	ocular trauma orbital wall fracture subconjunctival hemorrhage globe rupture entrapment vision loss Ophthalmology RE1-994 Terrill SB You H Eiseman H Rauser ME Review of Ocular Injuries in Patients with Orbital Wall Fractures: A 5-Year Retrospective Analysis
description	Stephanie B Terrill,1 Hyelin You,2 Heidi Eiseman,1 Michael E Rauser1 1Department of Ophthalmology, Loma Linda University Eye Institute, Loma Linda, CA, USA; 2Department of Ophthalmology, Loma Linda University School of Medicine, Loma Linda, CA, USACorrespondence: Michael E RauserLoma Linda University Eye Institute, 11370 Anderson Street, Suite 1800, Loma Linda, CA 92354, USATel +1 909 558 2112Email mrauser@llu.eduPurpose: The purpose of this study was to determine the incidence of minor and major ocular injuries in patients with orbital wall fractures at Loma Linda University Health, a level-one trauma center, to help determine the most appropriate setting for the initial dilated fundus examination by ophthalmologists.Methods: A retrospective study was performed from January 2008 to January 2013 of patients diagnosed with orbital wall fracture secondary to trauma. Exclusion criteria included unknown mechanism of injury, the absence of ophthalmology consultation, or absence of imaging. Data collected included age, gender, mechanism of injury, visual acuity, and anterior/posterior segment findings. Ocular injuries were categorized as either minor or major.Results: Of 567 charts reviewed, 460 met criteria and were included for analysis. In the analysis, 86.5% of patients were male, and 81.3% were Caucasian. The most common mechanism of orbital fracture was blunt injury. Visual acuity was better than 20/100 in 82.4% of patients. On chart review, 81.1% of patients were found to have either a minor injury, a major injury, or both. The most common injury was subconjunctival hemorrhage (53.5%). Globe rupture (2.9%) and vision-threatening posterior segment findings such as retinal tear and choroidal rupture (1.3%) were relatively rare. Only one retinal detachment (0.2%) was found, specifically in the setting of severe injury with concomitant globe rupture.Conclusion: Knowledge of the common ocular injuries associated with orbital fractures will help emergency department (ED) physicians and ophthalmologists provide the dilated fundus exam in the most appropriate setting. The most frequent injuries identified were non-vision threatening, and visually significant posterior segment findings were relatively rare (1.3%). Thus, for the majority of patients presenting to the ED with orbital fracture, a dilated fundus exam can be performed at a later date in the outpatient clinic setting, unless urgent orbital fracture surgery is planned.Keywords: ocular trauma, orbital wall fracture, subconjunctival hemorrhage, globe rupture, entrapment, vision loss
format	article
author	Terrill SB You H Eiseman H Rauser ME
author_facet	Terrill SB You H Eiseman H Rauser ME
author_sort	Terrill SB
title	Review of Ocular Injuries in Patients with Orbital Wall Fractures: A 5-Year Retrospective Analysis
title_short	Review of Ocular Injuries in Patients with Orbital Wall Fractures: A 5-Year Retrospective Analysis
title_full	Review of Ocular Injuries in Patients with Orbital Wall Fractures: A 5-Year Retrospective Analysis
title_fullStr	Review of Ocular Injuries in Patients with Orbital Wall Fractures: A 5-Year Retrospective Analysis
title_full_unstemmed	Review of Ocular Injuries in Patients with Orbital Wall Fractures: A 5-Year Retrospective Analysis
title_sort	review of ocular injuries in patients with orbital wall fractures: a 5-year retrospective analysis
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/2ae051c359e44f78a1581f9be6f6ac08
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Review of Ocular Injuries in Patients with Orbital Wall Fractures: A 5-Year Retrospective Analysis

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