[When should an orthoptic evaluation be prescribed in the management of orbital floor fracture? A prospective study of 47 fractures]

Rev Stomatol Chir Maxillofac Chir Orale. 2014 Nov;115(5):274-8. doi: 10.1016/j.revsto.2014.07.005. Epub 2014 Jul 28.
[Article in French]

Abstract

Introduction: We evaluated the indication of orthoptic evaluation for the management of orbital floor fractures in a prospective series.

Material and method: Forty-seven patients presenting with an orbital floor fracture were included in our prospective study. Consultations in orthoptics and maxillo-facial surgery were regularly carried out. Diplopia and motility were systematically assessed as well as a coordimetric examination according to Hess-Lees's technique.

Results: Nineteen percent of coordimetric motility disorders were observed among asymptomatic patients, after trauma. No diplopia or clinical motility disorder were observed 1 and 2 months after trauma, and coordimetric examinations came back to normal 2 and 3 months after trauma respectively for non-operated (26) and operated (21) patients.

Conclusions: An orthoptic evaluation is necessary for the management of orbital floor fractures to diagnose the type of diplopia, motility disorders, and to indicate a coordimetric examination if diplopia is present. We suggest this orthoptic evaluation for patients presenting with diplopia between 5 and 10 days following trauma, 1 month after trauma for non-surgical treatment and 2 months after trauma for surgical treatment.

Keywords: Diplopia; Diplopie; Fractures orbitaires; Ocular motility disorders; Orbital fractures; Troubles de la motilité oculaire.

Publication types

  • English Abstract

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Diagnostic Techniques, Ophthalmological* / statistics & numerical data
  • Diplopia / diagnosis
  • Diplopia / epidemiology
  • Diplopia / etiology
  • Eye Movements / physiology
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Orbital Fractures / complications
  • Orbital Fractures / diagnosis*
  • Orbital Fractures / epidemiology
  • Orbital Fractures / therapy*
  • Orthoptics* / methods
  • Young Adult