![]() Emphasis should be placed on evaluating for concomitant traumatic brain or cervical spine injuries. It's important to remember that patients with orbital floor fractures are also trauma patients. Fortunately, the overall incidence of vision loss with orbitalįractures is below 2 percent. When the optic nerve is also involved, the diagnosis becomes orbital apex syndrome. While uncommon, fractures of the orbit may extend posteriorly and involve CN III, IV, V1 and VI, resulting in superior orbital fissure, or Rochen-Duvigneaud syndrome. Less than 5 percent of fractures may result in the formation of a retrobulbar hematoma, which, in the presence of orbital compartment syndrome, requires emergent attention. ![]() The incidence of globe injury with orbital fractures ranges from 14-30 percent and may present as a corneal abrasion, retinal detachment, vitreous hemorrhage, traumatic hyphema or globe rupture. Orbital floor fractures may occur in isolation or as part of a pattern, such as zygomaticomaxillary complex and naso-orbital-ethmoid fractures. The optic foramen is located approximately 40-45mm posterior to the inferior orbital rim and is superior to the horizontal plane of the orbital floor. ![]() The thin-walled orbital floor is composed of mainly the maxillary bone and is the most fractured segment. The orbit is composed of seven different bones, the structure of which generally serves as a shock absorber for the globe. The provider is keen to point out that the radiologist is concerned for ocular entrapment and asks you to urgently evaluate. CT of the face confirms the presence of a unilateral orbital floor fracture. provider concerns an intoxicated, 23-year-old male who was involved in a bar fight. You're sewing a face laceration in the E.D. Message on your pager: 23 YOM S/P ASSAULT W/ ORBITAL FLOOR FX.
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