Following trauma there are several signs that are typical of on orbital fracture:
- Double vision when both eyes are open
- Cracking under the skin around the eye, especially noticeable after blowing the nose (although there may be a nose bleed as well, avoid blowing it as this can cause further injury)
- An increasing orbital pain following blowing the nose (again, this must be avoided)
Immediate orbital fracture repair is not always necessary. The foremost aim is to protect the orbit against infection and reduce swelling with antibiotics and anti-inflammatories. Avoid blowing the nose, as bacteria in the sinuses may enter the orbit and cause infection.
If the eye itself is not damaged but there is eyelid or canalicular damage, this should be repaired within 3 days of the injury.
Examination for Orbital trauma
Any periocular injury should be assessed by an oculoplastic surgeon.
Examination includes a vision test, a colour vision test, assessment of eye movement and pupil examination. Drops may be required to examine the retina and optic nerve.
If an orbital fracture is suspected, a CT scan of the skull will confirm the diagnosis. Appropriate treatment can then be planned.