What are the symptoms of sunken eyeball due to orbital fracture

Orbital fractures can easily cause sunken eyeballs, and may also be accompanied by orbital bleeding, excessive tears or subconjunctival hemorrhage. They can also directly affect eye movement, causing eye movement disorders, decreased vision, visual impairment and other dangers.

1. Symptoms

(1) Symptoms of acute fracture: intraorbital hemorrhage, periorbital edema, periorbital ecchymosis, subconjunctival hemorrhage, and subcutaneous emphysema.

After 7 days, the swelling will subside and the enophthalmos will be revealed. (2) Enophthalmos: Fractures often cause the orbital cavity to expand, causing the eyeball to shift downward and backward. In the early stage, it may not be obvious or the eyeball may protrude.

(3) Ocular movement disorders: may be caused by displacement, traction or entrapment of the extraocular muscles.

(4) Diplopia: Sunken/invaginated eyeballs, extraocular muscle damage, and ocular motor nerve damage can all cause diplopia.

(5) Visual impairment: In the early stage, it is mostly caused by corneal trauma, penetrating eye injury, optic canal fracture, optic nerve contusion, etc.

Injury or retinal disease. In the later stage, it may be caused by glaucoma, leukoplakia, cataract and optic nerve atrophy.

(6) Periorbital numbness: mostly caused by damage to the infraorbital nerve or supraorbital nerve. [3]?

Testing

(1) Plain film: Fahrenheit film can show the orbital roof and orbital floor. This view allows for indirect signs of fracture, such as a teardrop appearance or air-fluid levels. Plain radiographs cannot show orbital wall fractures well and cannot locate foreign bodies.

(2) CT: Axial, coronal and three-dimensional reconstructed CT images can be combined to clarify the specific circumstances of orbital rim and orbital wall fractures and soft tissue injuries, select surgical indications, and guide the formulation of surgical plans.

(3) MRI: MRI can be used to evaluate soft tissue damage in orbital trauma.

2. Surgical treatment

If clinical examination and CT scan reveal risk factors for enophthalmos and diplopia, surgery should be performed as soon as possible.

Traumatic diplopia may occur in the early stages of fracture. If CT scan does not reveal soft tissue and extraocular muscle incarceration and the extraocular muscle traction test is negative, no special treatment is required. If the symptoms of diplopia are obvious, eye movement is restricted, the extraocular muscle traction test is positive, and CT examination reveals incarceration of the extraocular muscles and surrounding tissues, surgical treatment is required in a timely manner.

In case of simple orbital floor or orbital wall fracture, approach through subtarsal incision or palpebral conjunctival incision and paracanthal incision respectively, carefully explore the orbital wall fracture area, restore the orbital contents trapped in the maxillary sinus and ethmoid sinus, and then fully expose the edge of the orbital wall defect area, especially the posterior border, and repair it with autologous bone or bone substitute pad. The normal orbital floor is arched behind the ball and protrudes into the orbit. This structure is difficult to restore and can be compensated by filling implants.