FRACTURE OF THE ORBIT
excerpt from the book Taking
Care of Your Eyes.
of your eyeballs lies within an orbit (eye socket), an open
cavity within the skull that is bordered by very thin bone.
If your eye or eye region is hit, as by a fist or ball, it
can cause the pressure within the orbit to suddenly increase.
The result can be a blowout fracture – a break
in one of the orbit bones and the possibility of the nerves
and extraocular eye muscles in the orbit being pushed through
the break. A blowout fracture of the orbit can be a very serious
any blood vessels have been broken, blood will swell into
the tissues and cause a classic swollen "black eye." After
the swelling goes down, the eye may appear to be sunken back
because the tissues have been pushed out of the orbit through
the broken bone. You may also have double vision (diplopia)
whenever you look up or down. Occasionally the lower part
of the cheek and some of the upper back teeth on the same
side as the fractured orbit become numb. Very rarely, severe
pain and nausea occur immediately after the injury.
the eye may have been hit directly, it will be thoroughly
examined to determine the extent of the injury. Your vision
will be evaluated and the inside of the eye will be examined
with an opthalmoscope. If a blowout fracture is suspected,
various X-rays may be taken of the orbital bones and other
facial bones. If swelling is so severe as to make a thorough
eye examination painful, or even hazardous, it may be postponed
for a few days. It may be necessary to wait a week or two
for the swelling to go down before a decision can be made
as to final treatment.
of any injuries to the eyeball will depend on the type and
extent of the damage. If there is no serious injury except
for the bone of the orbit, it may be allowed to heal without
any treatment. But if it appears that double vision or a sunken
eyeball might be permanent, it may be necessary to surgically
repair the fractured bone, possibly sealing the hole with
a thin plastic implant.
repair of a "blowout" is rarely undertaken immediately and
can safely be postponed for up to two weeks if it is necessary
to let the swelling subside. Surgery to place an orbital implant
leaves little or no scarring and the recovery period is usually
brief. Hopefully, the surgery will provide a permanent cure,
but sometimes it provides only partial relief from double
vision or a sunken eye.