Orbital roof fractures: management of ophthalmic complications.
OBJECTIVE
To review the clinical features and management of patients with orbital roof fractures.


METHODS
Non-comparative, retrospective case review of 21 patients presenting with orbital roof fractures.


RESULTS
The orbital roof fractures in our series resulted from motor vehicle accidents, blunt trauma, head injuries, and penetrating orbital injuries. Associated orbital and ocular injuries included other ipsilateral orbital fractures (16 cases), traumatic optic neuropathy (3 cases), ptosis (2 cases), perforating eye injuries (2 cases), intraorbital foreign bodies (2 cases), and oculomotor nerve palsy (1 case). Six patients required surgical intervention for ophthalmic sequelae, which included motility problems (4 cases), lagophthalmos (1 case), and a retained intraorbital foreign body with a cerebrospinal fluid leak (one case). The outcome of surgery was favorable in all cases, with complete resolution of symptoms in five of six patients.


CONCLUSIONS
Orbital and ocular injuries are common in association with orbital roof fractures. A multidisciplinary approach to management is required because facial and cerebral injuries are also common. Most patients can be managed conservatively. The specific ophthalmic indications for surgical intervention are limited, but the outcome in these cases is gratifying.
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005129:Eye Foreign Bodies / Q000150:complications / Q000601:surgery; D015807:Eye Injuries, Penetrating / Q000150:complications / Q000601:surgery; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures / Q000379:methods; D009915:Orbit / Q000293:injuries; D009917:Orbital Fractures / Q000209:etiology / Q000601:surgery*; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000150:complications / Q000601:surgery