Other than this, the doctor will also look for: The eye will be examined and the doctor will gently touch and press the cheek and forehead of the patient to look for distortion in these areas. If the patient is conscious, then the doctor will ask questions regarding the patient’s symptoms and the source and modality of the eye injury. Investigations to Diagnose Orbital Fracture Patient with Orbital Fracture has abnormally flat-appearing cheek, and there also may be severe pain in the cheek when the patient tries to open his/her mouth.There may be cuts on the eyelid and on the internal surface of the eye.Patient with Orbital Fracture may see flashing lights or “floaters” in the injured eye.If there is puffy accumulation of air beneath the skin near the eye, then it usually indicates that the fracture has broken the wall of the sinus cavity, maxillary sinus in particular, which is an air-filled chamber situated below the eye and inside the cheek.There is deformity and swelling of the forehead or cheek, with an obvious dent over the region of the broken bone.There is abnormal position of the eye, such as the eye has either sunken in or is bulging out of the socket.This can occur as a result of nerve damage due to the fracture. There is numbness in the eyelids, forehead, cheek, upper lip or teeth and on the side of the eye injury.Orbital Fracture causes difficulty in eye movements, such as looking up, down, right or left.Patient has decreased vision, double vision or blurry vision due to fractured orbital bone.There also may be redness and patches of bleeding on the sclera (the white part) of the eye and on the eyelids’ inner lining.There is swelling and black and blue discoloration around the injured eye due to fracture orbital bone.Symptoms of Orbital Fracture depend on the severity and location of the fracture and comprise of: Direct Orbital Floor Fracture: This is where the fracture to the orbital rim extends into the adjacent parts of the floor of the eye socket and there is fracture of the both the rim and the socket floor.It could be anything such as a fist, baseball, or dashboard of the automobile. Blowout fractures commonly occur as a result of impact to the anterior part of the eye from something which is bigger than the eye opening. This causes aberration in the eye movements resulting in double vision. The floor of the eye socket ruptures or cracks resulting in a small hole in the eye socket’s floor which can trap some parts of the eye muscles and its surrounding structures. Orbital Blowout Fracture or Indirect Orbital Floor Fracture: This is a fracture of the paper thin floor of the eye socket with the bony rim surrounding the eye remaining intact.Second one is frontal sinus fracture or frontal bone fracture which occurs in the upper edge of the eye rim and is also a part of the frontal bone of the forehead. Orbital Rim Fractures Are of Two Types: The first one is a zygomatic fracture which occurs in the lower edge of the eye rim and in also a part of the cheekbone. There also may be injuries to the eye, such as damage to the optic nerve, eye muscles, injury to the nerves which provide sensation in the cheek and forehead, damage to the sinuses surrounding the eye and the tear duct. These fractures occur due to a huge amount of force, and because of this force, patient also experiences extensive injuries to other facial bones, and sometimes even injuries to the brain. Orbital Rim Fracture: These occur as a result of direct impact to the face, often in car crashes from the face being hit into the steering wheel or an automobile dashboard.
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