Orbital Traumas, Foreign Body and Blow Out Orbital Fracture Surgery

In our country, trauma to the eye and orbital orbit is often caused by beatings and traffic accidents. More rarely, the orbit can be damaged after sports injuries. In severe traumas, the integrity of the eye may be impaired and permanent vision loss may be observed. In addition, only orbital injuries can be observed without eye damage. The orbit is a chamber (eye socket) formed by bone tissue on all four sides and filled with the eye, optic nerve, muscles that move the eye, and adipose tissue. Traumas coming here often lead to fractures in the bones forming the orbit (Blow out fracture). These fractures may be in the form of cracks depending on the severity of the trauma, or they may develop in a way that causes shape and displacement in the bones. Changes that occur in the orbit due to the effect of trauma are revealed in detail with radiological tests such as orbitatomography and/or MR examination, which are used in addition to clinical examination. Fractures often occur in the bones under and inside the eye, as they are thin and flimsy bones. Due to this fracture, the muscles and adipose tissue around the eye and eye are displaced towards the fracture site with the effect of this impact. Double vision in straight gaze or gaze positions can be added to the table due to this displacement due to eye pain, swelling and bruising due to trauma. In addition, if the cause of the trauma is a free foreign body, the foreign body may remain in the orbit, resulting in infection or loss of vision. Fractures may be accompanied by damage to the lid and tear duct. Such trauma cases should be evaluated as a whole and all structures should be repaired within days under emergency conditions. Subsequent correction may not always yield satisfactory results in cases that are delayed, omitted or neglected. For this reason, the first intervention should be a wedding. In these cases, while fighting infection and pain with medical treatment, surgical repair of fractures, repositioning of displaced ocular and extraocular structures, and removal of foreign bodies in necessary cases are essential. Damage to the lid and tear duct system should also be corrected at the same time. While implants are often used in the repair of fractures, silicone tubes are used for lid tear damage.

Dr. The 3 most frequently asked questions to Onur Konuk about orbital traumas, foreign body and blow out fracture surgery:

1. When an orbital fracture develops, does surgery always need to be performed?

Indications for surgery are collapse, double vision, and the large size of the fracture area, resulting in a cosmetically unsightly eye. Evaluation of this is done after clinical and radiological tests performed by the ophthalmologist who deals with oculoplastic surgery.

2. When is orbital fracture surgery performed? Is emergency intervention necessary?

Orbital fracture is a condition that needs urgent evaluation. The reason for this is that the uncontrolled healing of the fracture in the presence of fracture aggravates the picture. Therefore, the patient should be rapidly evaluated by oculoplastic surgery and an advanced treatment plan should be made.

3. How are orbital fractures repaired?

Orbital fracture surgery is often performed under general anesthesia. In these surgeries, oculoplastic surgeons make incisions inside the eye to minimize scarring. In this way, because there is no skin incision, no stitches are used and no scars are left. If the fracture line is wide, the skin and intraocular incisions are combined. For this reason, the skin incision is hidden in the skin folds and surgeries are performed without leaving any traces. The fracture line is repaired with silicone, bone or synthetic implants. These implants are not removed later.