View 2019 Abstracts

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.

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.

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.

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