title: Reduction in visual acuity and intraocular injuries in orbital floor fracture.
abstract: Blow-out fracture of the floor of the orbit is an increasingly recognized trauma. It may be an isolated injury, but because of various mechanisms may be also accompanied by the damage of other components of the visual system. The triad of clinical symptoms in blow-out fracture of the orbital floor includes: double vision, the enopthalmos and impaired sensation in the area of infraorbital nerve. Change of the position of the eyeball may lead to displacement and stretching of the optic nerve, which may result in the traumatic optic neuropathy. The aim of this paper is the evaluation of effectiveness of surgical and conservative tactics in the treatment of blow-out fracture of the floor of the orbit, accompanied by intraocular injuries, on the basis of retrospective study of the patients treated from 1971 to 2014.
  
  
  METHODS
  Based on a retrospective analysis of medical records of a group of 752 patients treated in our Department due to blow-out fracture of the orbit, during 44 years (1971-2015), intrabulbar injuries were found in 98 (13%) patients, and decrease in visual acuity was observed in 84 (11.2%) patients. In patients with decreased visual acuity values of sight acuity ranged from light perception to 0.8, in 3 patients the blow-out fracture of the orbit was accompanied by the superior orbital fissure syndrome, while in four patients orbital apex syndrome was observed. Statistical analysis of parameters of sight acuity before and after treatment was performed. The Wilcoxon test was used for dependent measurements (repeated), visual acuity after treatment was significantly higher than before. Due to the complexity of the injury, treatment of orbital floor fracture requires a multidisciplinary approach, in the team of maxillofacial surgeon, ophthalmologist, radiologist and neurologist.
authors.affiliation: Department of Cranio-Maxillo-Facial, Oncological and Reconstructive Surgery, Jagiellonian University Medical College, Szpital Specjalistyczny im. L. Rydygiera, Krakow, Poland. piotrskoryczan@gmail.com.
authors.forename: Piotr
authors.initials: P
authors.lastname: Koryczan
authors.forename: Jan
authors.initials: J
authors.lastname: Zapała
authors.forename: Grażyna
authors.initials: G
authors.lastname: Wyszyńska-Pawelec
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D020221:Optic Nerve Injuries / Q000601:surgery*; D009917:Orbital Fractures / Q000601:surgery*; D011044:Poland; D019736:Prostheses and Implants; D019651:Plastic Surgery Procedures / Q000379:methods*; D020127:Recovery of Function; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology*; D014794:Visual Fields / Q000502:physiology
keywords: blow-out fracture of the orbit; intraocular injury; traumatic optic neuropathy