Fracture explosions: Classifications, indications, and recovery methods
Blowout fractures are a type of injury that affects the bones surrounding the eye. These fractures occur when a blunt force is directed at the eye, with or without pressure towards the eye rim [1].
The Anatomy of the Eye
The eye is protected by a concave compartment known as the orbit. The thinnest of the eye bones, the orbital floor, is often the bone that fractures in a blowout fracture [2]. The orbit holds the eye in place and, in a blowout fracture, one or more of the orbital walls may fracture, causing the herniation or entrapment of orbital tissues [3].
Common Types of Blowout Fractures
There are several types of blowout fractures, each involving fractures to the orbital walls without involving the orbital rim. The most common type is the orbital floor fracture, where the floor of the orbit breaks, and orbital tissues such as fat or the inferior rectus muscle may herniate into the maxillary sinus [1]. Other types include medial wall fractures, apical fractures, superior wall fractures, lateral wall fractures, and multiple wall fractures [1].
Symptoms of Blowout Fractures
Symptoms of a blowout fracture may include pain and bruising around the eye, swelling of the forehead, cheek, or around the eye, pain or difficulty moving the eye, diplopia (double vision), blurry or decreased vision, numbness (especially of the cheek or upper lip due to infraorbital nerve involvement), visible changes such as an eye bulging (exophthalmos) or sinking inward (enophthalmos), blood in the white part of the eye, and the "white eye blowout" presentation, where there is minimal external bruising but signs of muscle entrapment causing restricted eye movement [2].
Treatment for Blowout Fractures
Treatment for a blowout fracture depends on the severity of the injury. Simple blowout fractures cause minimal or no double vision and minimal or no loss of tissue in the eye compartment once the initial swelling goes down [4]. In such cases, treatment may include applying ice, taking decongestants, avoiding blowing the nose while healing, and in some cases, using steroids or antibiotics [5].
For more severe cases, where there is muscle entrapment causing restrictive eye movement or diplopia, retrobulbar hematoma, persistent or clinically disturbing enophthalmos (sunken eyeball), hypoglobus (downward displacement of the globe), or cerebrospinal fluid (CSF) leaks, surgical intervention may be necessary [5]. Surgery aims to restore the orbital anatomy and function.
In pediatric populations, trapdoor fractures require careful monitoring due to the potential of muscle entrapment and the need for timely intervention to prevent vision loss [1][2][4].
Potential Complications and Long-Term Effects
Blowout fractures can sometimes result in long-term complications, including vision problems, infections, or displacement of the eye [6]. Surgery for a blowout fracture can also cause complications, such as displacement and scarring of the lower eyelid, tissue herniation if an implant is not placed correctly, or infection [5].
Conclusion
Blowout fractures are a common type of eye injury, particularly affecting the orbital floor and the medial orbital wall. A thorough medical evaluation is necessary to determine the type and severity of an eye injury and prevent long-term problems. If you or someone you know has received a blow to the eye area, seek medical help as soon as possible, especially if symptoms such as nausea, vomiting, difficulty looking upward, pain when moving the eye, severe double vision, or symptoms of infection such as swelling, pus, or fever are present [7].
[1] Orbital Fractures
[2] Blowout Fracture
[3] Orbital Fracture
[4] White Eye Blowout Fracture
[5] Orbital Floor Fractures: Management and Outcomes
[6] Complications of Orbital Fractures
[7] Blowout Fracture Symptoms
- In addition to blowout fractures, other eye problems that might warrant medical attention include various medical-conditions related to eye-health and health-and-wellness, such as diabetic retinopathy or glaucoma.
- If a person experiences fractures in the bones surrounding the eye, they may also encounter issues such as the herniation of orbital tissues, which can be related to the science of anatomy and ophthalmology.
- As part of a holistic approach to maintaining health-and-wellness, individuals should be aware of the symptoms and potential complications associated with blowout fractures and other eye-health issues to ensure timely medical intervention and preserve their eye-health.
