Eye Socket Repair (Fractures)

The eye socket (orbit) is a bony cup that surrounds and protects the eye. The rim of the socket is made of fairly thick bones, while the floor of the socket is paper thin in many places. A fracture is a broken bone in the eye socket involving the rim, the floor or both. When a patient suffers trauma near the eye, one of the bones of the orbit that surrounds the eye may be fractured. Orbital fractures may cause the eye to sink in and may cause limitation of the motility of the eye. Both of these complications can cause double vision.

Orbital rim fracture — These are caused by a direct impact to the face, most commonly by an automobile dashboard or steering wheel during a car crash. Because a great deal of force is required to cause these fractures, they often occur with extensive injuries to other facial bones, and sometimes injuries to the brain. Even if the damage is limited to the eye area, there may be additional injuries to the eye itself, such as the optic nerve (responsible for vision), the eye muscles, the nerves that provide sensation in the forehead and cheek, the sinuses around the eye and the tear duct. There are two types of orbital rim fractures. A zygomatic fracture involves the lower edge of the eye rim, which is part of the cheekbone. A frontal bone fracture or frontal sinus fracture involves the upper edge of the eye rim, which is part of the forehead's frontal bone.

Indirect orbital floor fracture ("blowout fracture") — This occurs when the bony rim of the eye remains intact, but the paper thin floor of the eye socket cracks or ruptures. This can cause a small hole in the floor of the eye socket that can trap parts of the eye muscles and surrounding structures. The injured eye may not move normally in its socket, which can cause double vision. Most blowout fractures are caused by an impact to the front of the eye from something bigger than the eye opening, such as a baseball, a fist or an automobile dashboard.

Direct orbital floor fracture — If an orbital rim fracture extends into nearby parts of the eye socket floor, both the rim and the socket floor are fractured.

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