Ocular sequelae of traumatic orbital fractures: A three-year epidemiological review within a Detroit hospital system

Abstract

Introduction Incidence of orbital fractures and associated ocular injuries has proven variable among literature worldwide. Such analysis has yet to be conducted in Detroit, Michigan. Due to the complexity and unpredictability of orbital fractures, we aim to further understand their epidemiology and association with ocular sequelae within this population. Methods This retrospective study analyzed 204 eyes of 187 patients over a three-year and seven-month period within a Detroit, Michigan hospital system. The incidence of ocular injuries resulting from computed tomography-confirmed orbital bone fractures was quantified and categorized based on patient demographic, fracture location, specific ocular injury, and need for surgical intervention with analysis. Results It was determined that 84.8% of orbital fracture patients sustained some form of ocular injury. Most fractures occurred within the city (55.1%), and most often occurred in males (63.6%). Fractures of the orbital floor were most often encountered. Commonly injured bones were maxillary, ethmoid, and zygomatic bones, respectively. Approximately one-third of patients with concurrent orbital fracture and ocular trauma sustained severe vision-threatening injury. These traumas are found to peak within summer months. Presence of retinal detachment is significantly related to orbital roof fractures, while maxillary bone fractures are associated with decreased incidences of retinal detachment. Approximately 23% of patients underwent immediate surgery for osseous fractures, while 3.26% of patients underwent immediate ocular surgical repair. Conclusion Our findings provide insight into the incidence of ocular injury in the setting of traumatic orbital fractures within a Midwest population. Both similarities and differences exist among our own results, and those of distinct geographical regions. These data shed light on Detroit's incidence of ocular sequelae in orbital fracture and contribute to a larger understanding of ocular and orbital trauma epidemiology.