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Eye Socket Fracture (Orbital Fracture)

What is an eye socket fracture?

The eye socket, or orbit, is made up of the bones that surround your eye. If the bones around your eye are hit hard enough, they can break. This is called an orbital fracture.

If your eye socket is treated successfully, and the injury to your eye or tissues around your eye was not too severe, you may not have any long-lasting effects from an eye socket fracture. If an eye socket fracture is not treated, you may develop a serious infection within the eyeball. You may also have double vision for the rest of your life.

What is the cause?

Injuries that can cause an eye socket fracture include:

  • Falls
  • Car accidents
  • Sports injuries
  • Being punched or kicked in your eye

One type of eye socket fracture that may not look bad, yet can cause serious problems, is a trapdoor fracture. The bone under your eye can swing down when broken and then swing shut, trapping the muscle that moves your eye down. Even if the bones do not look broken, a trapdoor fracture causes pain, severe double vision, nausea, and vomiting. This type of fracture is more common in children because their bones are more flexible than adult bones.

What are the symptoms?

Symptoms may include:

  • Decreased vision or double vision
  • Pain, bruising, drainage, tearing, bleeding, or swelling in and around your eye, nose, or cheeks
  • Numbness in your eyelids, cheek, side of the nose, upper lip, teeth and gums
  • Nausea and vomiting, which are more common in trapdoor fractures
  • Trouble moving your eye in one or more directions
  • Sunken eye, droopy eyelid, or an eye that bulges out
  • Swelling caused by air under the skin and that feels crunchy when touched

How is it diagnosed?

Your eye care provider will ask about your symptoms and your injury, and do exams and tests such as:

  • An exam using a microscope with a light attached, called a slit lamp, to look closely at the front and back of your eye
  • An exam using drops to enlarge, or dilate, your pupils and a light to look into the back of your eyes
  • Measurements to check the position of the injured eye compared with the normal eye
  • CT scan which uses x-rays and a computer to show detailed pictures of the bones of your eye socket and any blood behind your eye

How is it treated?

Your healthcare provider may prescribe antibiotics to prevent infections. Your provider may also prescribe steroid pills to decrease swelling.

Some eye socket fractures need to be repaired and others do not. Your fracture may need to be repaired if:

  • Your eye is sunken in.
  • You have severe double vision.
  • A muscle is trapped between the broken bones.
  • Many of the bones around your eye are broken and need to be put back into the right position.

If your eye was injured when your eye socket was broken, your eye also may need treatment.

How can I take care of myself?

Follow the full course of treatment prescribed by your healthcare provider. Also:

  • To keep swelling down and help relieve pain, your provider may tell you to:
    • Put an ice pack, gel pack, or package of frozen vegetables wrapped in a cloth on your eye every 3 to 4 hours for up to 20 minutes at a time for the first day or two after the injury.
    • Sleep with your head up on extra pillows.
    • Avoid straining while lifting, having a bowel movement, passing urine, blowing your nose, sneezing, or coughing for the first few days.
    • Take pain medicine, such as ibuprofen, as directed by your provider. Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your healthcare provider, do not take for more than 10 days.

Ask your healthcare provider:

  • How and when you will hear your test results
  • How long it will take to recover
  • What activities you should avoid and when you can return to your normal activities
  • How to take care of yourself at home
  • What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup.

How can I prevent eye socket fractures?

  • To help prevent severe eye injuries, wear safety eyewear when you:
    • Do any work around the house that requires hammering, power tools, chemicals, or splatter of any kind
    • Play paintball, racquetball, lacrosse, hockey, and fast-pitch softball
    • Shoot firearms or use explosives of any kind
    • Are in a high-risk area such as a construction site or shooting range
  • Always wear a seatbelt to decrease injuries from car accidents.

Reviewed for medical accuracy by faculty at the Wilmer Eye Institute at Johns Hopkins. Web site: http://www.hopkinsmedicine.org/wilmer/

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Published by RelayHealth.
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