Incidence of ocular injury in visually asymptomatic orbital fractures.
OBJECTIVE
To determine the incidence of severe ocular injury in visually asymptomatic patients with orbital fractures.


METHODS
Retrospective review of 241 cases of orbital fracture, of which 126 cases had ophthalmic evaluation within 1 week of injury and were included in our analysis. Fracture type, associated symptoms, and injuries were evaluated. Injuries were categorized into severe (requiring immediate evaluation), moderate (requiring evaluation within the next several days), and mild (may not require evaluation). The presence of symptoms and associated visual acuity and severity of injury were analyzed for statistical significance.


RESULTS
Forty-six of 126 patients with orbital fractures were visually asymptomatic. Of these patients, none had severe injuries, 15 had moderate injuries, 23 had mild injuries, and 8 had no injuries. Of those with symptoms, 15 had severe injuries, 27 had moderate injuries, 35 had mild injuries, and 3 had no injuries. Using Fisher exact test analysis, asymptomatic patients were unlikely to have severe ocular injury in the setting of orbital fracture (p = 0.0009). In addition, visual acuity did not accurately predict the presence of severe ocular injury.


CONCLUSIONS
Visually asymptomatic patients with orbital fractures do not have ocular injury requiring emergent evaluation.
Mellema
Peter A
PA
Department of Ophthalmology, University of Minnesota, Minneapolis, Minnesota, MN 55455, USA.
Dewan
Mohit A
MA
Lee
Michael S
MS
Smith
Scott D
SD
Harrison
Andrew R
AR
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005131:Eye Injuries / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D009917:Orbital Fractures / Q000175:diagnosis / Q000453:epidemiology*; D011379:Prognosis; D012189:Retrospective Studies; D015599:Trauma Severity Indices; D014792:Visual Acuity; D055815:Young Adult