Clinical Signs and Intraocular Pressure Changes in Patients with Orbitozygomatic Complex Fractures

Abstract

Objectives: The study investigated the association between intraocular pressure changes and clinical ocular signs in 51 patients with orbitozygomatic complex fractures. Diplopia, chemosis, enophthalmos, subconjunctival haemorrhage, periorbital ecchymosis and extraocular muscles entrapment were assessed.

Study design: Intraocular pressure was measured in mmHg at different time intervals with Perkins and Goldman tonometers; within first 3 days of injury (T1), 24 h post-elevation within 3-14 days of injury (T2), 1 month after initial treatment assessment (T3), 2 months after initial treatment assessment (T4), and 3 months after initial treatment assessment (T5). Intraocular pressure changes between T2/T1 and T3/T1 were analysed as change 1 and change 2, respectively, with paired t test. Significance was set at p < 0.05.

Results: Minimum intraocular pressure recorded in the affected eye was 5 mmHg at T1 and T2, while maximum intraocular pressure was 28 mmHg at T1. Mean intraocular pressure at T1 and T2 was 15.90 ± 4.73 mmHg and 16.80 ± 4.43 mmHg, respectively. All eye signs had completely resolved at T3 except enophthalmos, which persisted till T5. Statistical significant relationship exist between orbitozygomatic complex fracture and enophthalmos (T1: p = 0.04). subconjunctival haemorrhage (T2: p = 0.003), periorbital ecchymosis (T2: p = 0.005),and T3: p = 0.001).

Conclusion: Chemosis, diplopia, enophthalmos, periorbital ecchymosis and subconjunctival haemorrhage showed positive contributory effect to intraocular pressure elevation in orbitozygomatic complex fracture.

Keywords: Blindness; Intraocular pressure changes; Ocular eye signs; Orbitozygomatic complex fractures; Trauma.

Fig. 1

Intraocular pressure changes of affected eyes in orbitozygomatic complex fractures