View 2019 Abstracts

TitleOrbital Trauma in a Regional Orbito-facial Trauma Centre
Submitted byAhmed ALNAHRAWY
Abstract Number118
Review Resultrapid fire presentation
Purpose

Complex orbital fractures require multi-specialty input. There are no nationally agreed best practice guidelines (BAOMS Trauma Specialist Group Lead). A recent meta analysis established that patients fractures operated on more than 14 days post injury had a significantly increased risk of persistent diplopia.

Methods

We collected data on all patients presenting to a regional orbito facial trauma centre over a 3.5 year period referred for orbital and ophthalmic assessment between December 2014 to June 2018 including demographics, eye and orbital injuries, management and outcomes.

Results

324 patients, Age range 15-89, 282 patients (87%) below 60 yrs of age, 42 patients (13%) above 60. Assault in 219 patients (67%) was the most common mechanism of injury in the under 60s and falls 16 patients (73%) for above 60s age group
Isolated fractures in 221 patients (65.5%) while complex fractures 32 (9%)
92% of patients presented with ocular motility problems that improved after surgery.
42 cases residual ocular motility needing referral to strabismus clinic . Strabismus surgery was needed for 14 patients (4%)
14% were left with residual diplopia
7 (2%) patients with Traumatic Optic Neuropathy
The timing of injury to eye assessment was within first week for 42 patients (13%), second week 229 patients (70%) and 53 (16%) patients were seen after 2 weeks. 195 patients (60%) went for Orbital Fracture Repair.

Conclusion

A clear referral pathway from trauma to OMFS via ophthalmology is essential to ensure patients are treated in a timely fashion as this would reduce need for reoperationa and maximise final outcome


Additional Authors

Last nameInitialsCity / HospitalDepartment
ChanCImperial College Healthcare NHS Trust, London
LeeVImperial College Healthcare NHS Trust, London
JainRImperial College Healthcare NHS Trust, London
AzizAImperial College Healthcare NHS Trust, London
PerryMLondon North West University NHS Trust, London
BalasundaramILondon North West University NHS Trust, London