Summary

  • Traumatic injuries usually caused by sports and interpersonal violence. In children, play and accidents are the most common causes.
  • A careful evaluation of the orbit injury may include examination of the facial bones, eyelids, and surrounding soft tissue; inspection of the globe; and visual acuity.
  • A definitive diagnosis is confirmed by CT scan of the orbit.
  • Urgent surgery is indicated in pediatric patients with signs of soft tissue (muscle) entrapment; namely upgaze limitation and the oculovagal response (presence of vagal stimulation by pressure to intraorbital structures, which results in bradycardia, hypotension, and nausea and/or vomiting). Surgery is delayed in most adult cases to allow edema and hemorrhage to resolve. In small, non-blowout fractures, conservative treatment may be considered.
  • The use of goggles or safety glasses in contact sports is recommended to prevent orbital fractures and associated injuries.

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