Orbital wall fractures are caused mainly by bruising of the orbital areas, and are roughly divided into those with or without orbital rim fracture, or by type, punch-out or linear. Symptoms are primarily enophthalmos and ocular movement disorder, and surgical treatment is performed in cases in which symptomatic improvement cannot be obtained by conservative treatment. The surgical indications are muscle entrapment and moderate or severe ocular depression. However, not all patients presenting with double vision at the initial examination have orbital wall fractures. Therefore, bleeding and swelling or edema of the orbital area may impair vision, and be subacute symptoms that disappear spontaneously. Time course image diagnosis is helpful to decide the correct management.
In this report, we describe a 5-year statistical study performed at our unit, and a strategy for orbital wall fractures, including those with rim and apex injuries, illustrating its diagnosis, decision on emergency or stand-by operation, and its procedure.
