Orbital (Eye Socket) Fractures

The orbit, or eye socket, is a bony cavity that surrounds and protects the eye. While the rim of the orbit is made of thick bone, the floor and nasal walls are very thin and susceptible to fractures. Orbital fractures can involve the rim, floor, nasal wall, and in rare cases, the roof or outer wall after severe trauma.

Types of Orbital Facial Fractures

Orbital floor and/or nasal wall fracture (“blowout fracture”): The bony rim remains intact, but the floor of the socket breaks. This can occur after motor vehicle accidents, sports injuries, or a punch to the eye.

Orbital rim fracture: Often occurs with extensive facial injuries and sometimes with brain trauma.

Tripod fracture: A fracture of the cheekbone combined with a blowout fracture.

Symptoms

Abnormal position of the eye (bulging or sunken)
Flattened appearance of the cheek, with pain when chewing or opening the mouth
Bruising and swelling around the eye
Difficulty moving the eye in any direction
Double vision, blurred vision, or decreased vision
Numbness in the cheek, upper lip, or upper teeth on the same side as the fracture
Swelling or deformity of the cheek or forehead

Test

Comprehensive Exam: Your doctor will examine your eyes and face and review how the injury occurred, as well as your medical history.

Imaging: A CT scan is typically used to confirm the fracture and assess its extent.

Treatments

Non-Surgical Management

Cold compress: To reduce swelling and pain.
Nasal decongestants: To control swelling around the eye.
Antibiotics: To prevent infection near the fracture.
Rest: Avoid strenuous activity and forceful nose blowing to prevent complications such as air under the skin.

Surgery

Post-Operative Care

Ice packs for the first 48 hours while awake
Sutures may lift the lower eyelid for about a week
Antibiotic ointment applied to the eye three times per day for a week (may blur vision)
Oral antibiotics may be prescribed
Temporary double vision and increased numbness on the affected side are common but usually resolve over time

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FAQ

What causes orbital fractures, and how do they impact the eye?

Orbital fractures, or blowout breaks in the eye socket’s thin walls (often floor), happen from blunt hits like sports balls or fists, trapping muscles or fat and shifting the globe—like a car bumper dent trapping the wheel. This sparks double vision, sunken eyes, or numbness, but most heal well if addressed timely, preserving alignment and sensation.

What immediate symptoms follow an orbital fracture?

Swelling shuts eyes like puffy pillows, bruising raccoons cheeks, and diplopia twists views when looking up/down—enophthalmos (sunken globe) or infraorbital tingling flags entrapment. Pain’s mild, but restricted motion screams “”fix me,”” especially post-assault or accident.

How are orbital fractures diagnosed accurately?

Thin-slice CT scans blueprint breaks and entrapments like a 3D crime scene, while forced duction tests under anesthesia probe muscle sticks. Clinical: eye motility charts and exophthalmometry measure shifts—ER gold standard, guiding if watch-and-wait or operate.

What does surgical repair of an orbital fracture involve?

Via intraoral or lid incisions, surgeons insert titanium mesh or grafts to rebuild volume, freeing traps—1-2 hours under general, often same-day out. Timing: 7-14 days post-swell down, optimizing diplopia fix in 90% without scars showing.

What recovery and prevention tips apply to orbital fractures?

Ice/head elevation first 72 hours, no nose-blowing (air emphysema risk); diplopia fades weeks, numbness months. Helmets/glasses prevent—sports stars swear by them. Most resume full activities in 4-6 weeks, faces firmer, visions fused.