Eye Disorders

Complications of Orbital Fracture Repair

Most common complication of orbital floor fracture repair is diplopia. Up to 75% combined orbital floor and medial wall fractures may have clinically significant diplopia six months postoperatively. Damage directly to globe or to optic nerve, eyelid avulsion, damage to lacrimal apparatus, haemorrhage, damage to infraorbital nerve.

Eye Injuries

In the first 24 hours after an eye injury, blood leaking into skin around the eye usually produces a bruise (contusion): black eye. Damage to the inside of eye is more serious and injury to face can fracture any of several bones that form the orbits. The fracture may impair function of muscles that move the eye, producing double vision or inhibiting eye movement to the right, left, up or down.

Papilloedema

The condition in which increased pressure around brain causes the optic nerve to swell where it enters the eye is known as papilloedema. This almost always occurs in both eyes and is usually caused by a brain tumour or abscess, head injury, bleeding in brain, infection of meninges, pseudotumour cerebri, cavernous sinus thrombosis or severe high blood pressure. Severe lung diseases can also lead to papilloedema and this may at first cause headaches without affecting vision.

If there is no papilloedema, there is no evidence or reason to necessarily suspect a tumour. In the case of injury to the eye (temporal bone area) there is a very high chance of an orbital floor fracture and muscle/nerve damage. The third cranial nerve controls the extrinsic muscles and the sixth cranial nerve controls the lateral rectus muscle and trochlear nerve by fourth cranial nerve. If vision is impaired upwards and to right extreme the 4th and 6th nerve/muscle to right eye are implicated. So, a fracture of the bone in the orbit floor and partial detachment or damage to the muscle cause restricted movement in a particular direction.