Occurrence of ocular injury and orbital fracture in orbital blunt trauma patients at tertiary care center emergency room

• Published in: Graefe's archive for clinical and experimental ophthalmology 2021, Vol.259 (1), p.165-171
• Main Authors: Noh, Hoon, Chung, Joon Kyo, Woo, Kyung In, Kim, Yoon-Duck
• Format: Article
• Language: English
• Subjects: Computed tomography; Emergency medical care; Injuries; Medicine; Medicine & Public Health; Oculoplastics and Orbit; Ophthalmology; Trauma
• ISSN: 0721-832X; 1435-702X
• DOI: 10.1007/s00417-020-04786-6

Purpose To analyze the prevalence and association of ocular injury and orbital fracture in orbital trauma patients Methods Patients with periocular trauma who visited the emergency room at the referral center from 2014 to 2016 were screened. Patients examined by ophthalmologists and evaluated by CT scan were included. Patients’ age, gender, cause of trauma, and injury patterns were retrieved. The location of the fracture and morphologic parameters were reviewed. The patients were divided into groups based on the presence of orbital fracture and/or the presence of ocular injury and clinical data were compared. Results Two hundred patients were included and 158 presented with fracture. Ocular injuries occurred in 129 of 158 (81.6%) in the fracture group, and in 40 of 42 (95.2%) in the no fracture group; ocular injuries were found more often in the no fracture group ( p = 0.031). Open globe injuries occurred in 5 of 158 (3.2%) in the fracture group and in 6 of 42 (14.3%) in the no fracture group; open globe injuries were found more often in the no fracture group ( p = 0.012). Patients with ocular injuries showed shorter depth of the orbit (41.9 vs. 44.1 mm; p = 0.003) compared to the patients without ocular injuries. Logistic regression revealed that short orbit was associated with the presence of ocular injury ( p = 0.004). Conclusion The incidence of ocular injuries was significantly higher in patients without orbital fracture than in those with fractures of the orbit. The orbital fracture may play a protective role against ocular injury by providing a decompressive effect on the orbital tissue.