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Orbital Blowout Fracture Surgery

Orbital blowouts can be distressing injuries, with many possible complications, pain, and slow healing times too. Fortunately a good surgeon may be able to help you resolve these issues. In many cases after a blow to the eye orbital blowout surgery may be necessary to help you regain vision, reduce pain, and prevent further injury or damage to the area.

What is an orbital blowout fracture?

An orbital blowout fracture is a fracture of the bones in the floor (inferior wall) of the orbit. This fracture results in instability of the orbit. This creates problems when the floor of the orbit cannot support the lateral and medial wall or the roof of the orbit. In these cases the eye may become unstable as well.

How do orbital blowout fractures occur?

Significant force or trauma is the cause of almost all orbital blowout fractures. When an injury occurs in the eyebrow areas and upper cheeks it is likely for this type of fracture to occur. The force exerted on these areas will be felt in the orbital region as well and if they are strong enough a fracture is likely to occur. Such fractures may occur from vehicle crashes, sports injuries, or fist fighting too.

What symptoms will I have with orbital blowout fracture?

Symptoms may vary from patient to patient, but below are the most common symptoms.
• Pain in the orbital area
• Bruising
• Air beneath the skin surrounding the orbital
• Redness of the eye
• Double or blurred vision
• Bleeding of the nose
• Numbness throughout the cheek, nose, or mouth

How is orbital blowout fracture treated?

Simple blowout fractures may be able to heal with only pain management needed along with care for the injured area including ice. Other large fractures may require surgery. Some of the most common reasons for orbital blowout surgery include:

• Extensive injury to the area
• Persistent double vision
• Chronic or unrelieved pain through nonsurgical means
• Entrapped muscle or soft tissue within the injury

Orbital blowout surgery and its complications:

Most surgeons prefer transconjunctival methods rather than transcutaneous, meaning that they will enter through the conjunctiva of your eye rather than the skin surrounding your orbit near the cheek and eye brow. While most orbits can be repaired, some orbital floors have to be replaced when damaged very badly. This is accomplished by placing a titanium plate along the rim of the eye and a polyethylene plate on the floor of the orbit, between the globe of the eye and the sinus below. In both cases, whether repair or replacement occurs, the goal is to retain the eye within the orbit and restore stability to the entire orbit itself. Most surgeries are very successful though chronic pain, double vision, and visual disturbances have been reported.