Facial trauma and ocular/orbital injury.
OBJECTIVE
Ocular injuries occur commonly in patients with facial trauma. Patients with significant eye injuries may present with grossly normal eyes and good visual acuity; however, subsequent ocular disorders may become apparent. The estimates of incidence vary considerably. Trauma is the second leading cause of blindness, and a review is, therefore, warranted.


METHODS
Several extensive studies are reviewed. Blunt and penetrating trauma are examined by their respective subdivisions. The initial assessment and ophthalmologic examination of patients with facial trauma are discussed, and the type of injury that may occur secondary to trauma is delineated. Management is reviewed and discussed, including a recently developed diagnostic scoring system. Three clinical cases illustrate the procedure.


CONCLUSIONS
The diagnosis of ocular injuries resulting from trauma is difficult. The recently introduced scoring system was found to improve the procedure. Based on this system, the authors have devised an algorithm to assist the clinician, with emphasis on visual acuity and the importance of visual examination.
Larian
B
B
Division of Head and Neck Surgery-Otolaryngology, Department of Surgery, University of California School of Medicine, Box 951749, Los Angeles, CA 90095-1749, USA.
Wong
B
B
Crumley
R L
RL
Moeinolmolki
B
B
Muranaka
E
E
Keates
R H
RH
D000328:Adult; D000465:Algorithms; D001766:Blindness / Q000209:etiology; D002648:Child; D005130:Eye Hemorrhage / Q000175:diagnosis; D005131:Eye Injuries / Q000145:classification / Q000150:complications / Q000175:diagnosis*; D015807:Eye Injuries, Penetrating / Q000145:classification; D005143:Eyelids / Q000293:injuries; D005151:Facial Injuries / Q000150:complications*; D005260:Female; D006801:Humans; D006988:Hyphema / Q000175:diagnosis; D022125:Lacerations / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D009901:Optic Nerve Diseases / Q000175:diagnosis; D009917:Orbital Fractures / Q000150:complications*; D012163:Retinal Detachment / Q000175:diagnosis; D019315:Retrobulbar Hemorrhage / Q000175:diagnosis; D014792:Visual Acuity; D014823:Vitreous Hemorrhage / Q000175:diagnosis; D014949:Wounds, Nonpenetrating / Q000145:classification