title: Ocular findings in patients with orbitozygomatic complex fractures: a retrospective study.
abstract: OBJECTIVE
  To evaluate the incidence of ocular injuries and clinical ocular signs in patients with orbitozygomatic fractures of varying severity, presenting to a regional oral and maxillofacial surgery service.
  
  
  METHODS
  This is a retrospective study of patients presenting to Limerick Regional Hospital (Limerick, Ireland) with orbitozygomatic fractures from January 1998 to December 2004. Patients with panfacial fractures and those with isolated zygomatic arch fractures were excluded. All patients were examined by the ophthalmology service preoperatively and reviewed postoperatively as indicated. The study population was divided into 3 subgroups based on the extent of the bony injury (confirmed by clinical, plain radiographic, and CT examination) as follows: group 1: "simple" noncomminuted orbitozygomatic complex fractures; group 2: comminuted orbitozygomatic complex fractures; group 3: "pure" orbital blowout fractures. Patient demographics, fracture etiology, and ocular findings were recorded.
  
  
  RESULTS
  The study population included 148 patients (130 males, 18 females). All fractures were unilateral. Ocular findings were present in 29 (20%) patients, consisting of 8 of 85 patients (9%) in group 1; 15 of 53 patients (28%) in group 2; and in 6 of 10 patients (60%) in group 3.
  
  
  CONCLUSIONS
  Clinical ocular findings and injuries are a relatively common complication of orbitozygomatic fractures, occurring in 29 (20%) patients in this study. These injuries occur more often in patients with orbital blowout fractures compared with comminuted orbitozygomatic complex fractures or simple orbitozygomatic complex fractures. Ophthalmology consultation is recommended for all patients presenting with orbitozygomatic fractures, and is essential for patients with orbital blowout fractures, based on the high incidence of clinical ocular findings and injuries in this subgroup of patients.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Limerick Regional Hospital, Limerick, Ireland.
authors.forename: Conor
authors.initials: C
authors.lastname: Barry
authors.forename: Margaret
authors.initials: M
authors.lastname: Coyle
authors.forename: Zubair
authors.initials: Z
authors.lastname: Idrees
authors.forename: Marie Hickey
authors.initials: MH
authors.lastname: Dwyer
authors.forename: Gerard
authors.initials: G
authors.lastname: Kearns
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D004172:Diplopia / Q000209:etiology; D015841:Enophthalmos / Q000209:etiology; D005131:Eye Injuries / Q000209:etiology*; D005260:Female; D018460:Fractures, Comminuted / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D009917:Orbital Fractures / Q000145:classification / Q000150:complications*; D012189:Retrospective Studies; D015051:Zygomatic Fractures / Q000145:classification / Q000150:complications*