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  • No.141/142, SAAI EYE HOSPITAL, Near GJR International School, Maruthi Layout, Chinnappanahalli, Kundanahalli, Marathahalli Bangalore-560037
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Saai Eye Hospital

Orbital Fracture

What is an orbital fracture?

An orbital fracture is when there is a break in one of the bones surrounding the eyeball (called the orbit, or eye socket). Usually this kind of injury is caused by blunt force trauma, when something hits the eye very hard.



What are the types of orbital fractures?

Orbital rim fracture

This injury affects the bony outer edges of the eye socket. Because the rim is made up of very thick bone, an injury to this area has to carry a lot of force for a fracture to occur. Car accidents are one of the main causes of this kind of fracture.

If someone has an orbital rim fracture, it is likely they have other injuries to the face, and possibly the optic nerve.

Blowout fracture

A blowout fracture is a break in the floor or inner wall of the orbit or eye socket. A crack in the very thin bone that makes up these walls can pinch muscles and other structures around the eye, keeping the eyeball from moving properly. Getting hit with a baseball or a fist often causes a blowout fracture.

Orbital floor fracture

This is when a blow or trauma to the orbital rim pushes the bones back, causing the bones of the eye socket floor buckle to downward. This fracture can also affect the muscles and nerves around the eye, keeping it from moving properly and feeling normal.



What are the symptoms of orbital fracture?

Symptoms of orbital fracture may include

  • blurry, decreased or double vision
  • black and blue bruising around the eyes
  • swelling of the forehead or cheek
  • swollen skin under the eye
  • numbness in the injured side of the face
  • blood in the white part of the eye
  • difficulty moving the eye to look left, right, up or down
  • flattened cheek
  • intense cheek pain when opening the mouth
  • bulging or sunken eyeballs


When should I consult a doctor?

If you suffer a blow to your eye, apply cold packs to the injured area for at least 15 minutes to help reduce pain, swelling and discoloration. Seek medical attention immediately if you experience any of symptoms of an orbital fracture.

Contact your doctor if you see flashing lights or "floaters" (spots or shadowy shapes) in your injured eye, or if you have a cut on your eyelid or on the inside surface of your eye.



How is an orbit fracture diagnosed?

If you are conscious and able to answer questions after your injury, your doctor will review your symptoms and ask how your eye injury occurred. He or she will examine your eye, and will gently touch and press on your cheek and forehead to check if these areas are distorted. The doctor also will check for:

  • Whether you can look upward, downward or sideways — If your doctor suspects that one of your eye muscles has become trapped in the fracture site, he or she may grasp the tendon of your eye muscle and attempt to rotate the eye by hand.
  • Changes in vision, especially double vision
  • Areas of numbness in your forehead, eyelids, cheek, upper lip and upper teeth
  • Internal damage — Your doctor will look inside your eye with an instrument called an ophthalmoscope to check for signs of internal damage. If the examination suggests you have an eye socket fracture, the doctor will confirm the diagnosis with X-rays or a computed tomography (CT) scan of the area around your eye.

In someone who is unconscious and has severe facial injuries, doctors can confirm the diagnosis of an eye socket fracture with X-rays and a CT scan of the eye socket bones. This is done after any life-threatening injuries have been addressed and the person's condition has stabilized.



Treatment for orbital fracture?

In many cases, orbital fractures do not need to be treated with surgery. If an orbital fracture is small, your ophthalmologist may recommend placing ice packs on the area to reduce swelling and allow the eye socket to heal on its own over time. Sometimes antibiotics and decongestants are prescribed as well. People with an orbital fracture should avoid blowing their nose for a while as they heal.

An orbital fracture is more severe when it keeps the eye from moving properly, causes double vision or has repositioned the eyeball in its socket. In this case, the ophthalmologist may refer the patient to an oculoplastic surgeon for surgery.

In many situations, the oculoplastic surgeon will choose to wait for a period of time to see how the healing process goes before doing surgery. Waiting until swelling goes down before surgery often leads to better outcomes. If the orbital fracture symptoms go away, it may be possible to avoid having surgery and any possible related complications.



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