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Abstract Orbital trauma can damage both the facial bones & adjacent soft tissues. Fractures may be associated with injuries to the orbital contents, intracranial structures & paranasal sinuses. Orbital hemorrhage & embedded foreign bodies may also be present & have 2ry effects upon the orbital soft tissues. The commonly encountered orbital fractures are blow out fracture of the orbital floor & medial wall fracture but also injuries to the orbit can result in intra-orbital hematoma , an indirect (traumatic) optic neuropathy or more severely Le Fort fracture (types II or III).The bones of the orbital apex can also be fractured in association with other fractures of the face and orbit. These fractures are often difficult to manage owing to the high risk of optic nerve dysfunction from compression by edema and bone, and from disruption of its vascular supply. Presentation can vary from diplopia, enophthalmos, ptosis, restricted orbital motility, decreased visual acuity or hyposethia over the cheeks. Diagnostic aids for a case of orbital trauma include CT scan, 3D CT scan, Multidetector CT scan. A multidisciplinary approach with the neurosurgeon, the otolaryngologist, and the oral surgeon may be indicated for severe facial injuries. Isolated fractures of the floor or medial wall without involvement of the orbital rim are classified as indirect or “blowout” fracture For orbital floor fractures, non-resolving oculocardiac reflex, the ”white-eyed” blowout fracture, and early enophthalmos or hypoglobus are indications for immediate surgical repair. Surgery within 2 weeks is recommended in cases of symptomatic diplopia with positive forced ductions and evidence of orbital soft tissue entrapment on computed tomography examination or large orbital floor fractures, which may cause latent enophthalmos or hypo-ophthalmos. |