الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
 |  | from | 105 |  |  |
| | | from | 105 | | |
Abstract
Traumatic ocular injuries are a leading cause of visual deficits. In acute trauma to the orbit, urgent oph¬thalmologic evaluation and intervention if needed are critical in preserving vision. However, in the acute trauma setting, clinical evaluation of the globe is difficult due to surrounding peri-orbital soft tissue edema and other regional injuries. Patient coop¬eration may be limited due to altered consciousness. Radiolo¬gists are the first to identify osseous injuries of the globe; thus, knowledge of the imaging appearance of orbital injuries (osseous and soft tissue) is critical in making accurate diagnosis to plan proper patient treatment.
The aim of this work was to highlight the role of MDCT in the assessment of orbital trauma. This study included 56 patients, 43 males (76.8%) and 13 females (23.2%), their ages ranged from 2 – 68 years, with a mean age of 30.6 years, 49 with unilateral and 7 with bilateral orbital injuries (63 eyes), the right eye was affected in 38 (60.3%) of our patients while the left eye was affected in 25 (39.7%) patients. 47 (83.9 %) patients were subjected to blunt trauma while 7 (16.1 %) patients presented with penetrating traumas. The most common cause of injury appeared to be road traffic accidents in 29 cases (51.8%) followed by violent assaults in 15 cases (26.8%). All patients presented to the emergency department and were subjected to full history taking, thorough ophthalmological examination, and radiological assessment using multi-slice CT done on a 64 slice machine in axial cuts and images were sent for post-processing and MPR on working stations.
Pain around the eye was found to be the most presenting symptom (58.7%), while orbital wall fractures were the most radiologically diagnosed injury (appeared in 45 eyes), the most common wall to be fractured appeared to be the orbital floor (50.8 %), followed by both the lateral and superior walls (both in 33.3 % of cases), while the medial wall came least in order of involvement (27 %) taking into consideration that some patients suffered from combined wall fractures. Other significant findings were diagnosed by CT including EOMs affection (17.4%), globe rupture (12.6%), retinal detachment (6.3%), vitreous hemorrhages (12.6%), lens dislocations (7.9%) and intra-conal foreign bodies (11.1%).
In this study we attempted to prove that in emergency orbital trauma setting, MDCT with high resolution bone algorithm is mandatory and can be considered the first diagnostic modality in cases of complex orbital trauma. Knowledge of different ocular injuries mechanisms and appearances on imaging aids reaching an accurate diagnosis and guides proper patient treatment.