Article
Visual outcomes of blunt ocular ruptures associated with orbital fractures
Search Medline for
Authors
Published: | June 18, 2008 |
---|
Outline
Text
Objective: To determine the association of orbital fracture and final visual acuity outcome among patients with a rupture open globe injury.
Methods/Design: A retrospective cohort review of 221 patients who presented to the Wilmer Ophthalmological Institute with open globe injuries from January 1, 2001, to December 31, 2004, was conducted.
Results: The study sample consisted of 221 patients with open globe injuries: 114 patients sustained ruptured open globes, 106 sustained lacerated globes, and 1 injury was undetermined. Chi-square p-values were used to determine independence between orbital fracture and visual acuity categories. Examining initial vision by the presence or absence of an associated orbital fracture shows that rupture open globe injury with an orbital fracture has similar initial vision compared to rupture open globe injury without an orbital fracture. However, evaluating final visual outcome by the presence or absence of an associated orbital fracture shows that rupture open globe injury with an orbital fracture has a worse final vision compared to rupture open globe injury without a fracture (p=0.05). Furthermore, 65.4% of patients with an orbital fracture and a rupture open globe were enucleated, compared to 36.5% of patients with a rupture open globe alone. Logistic regression was performed to determine factors associated with improvement in vision. Improvement in visual acuity was associated with not having an orbital fracture: 41.9% of those without fracture improved in acuity compared to 14.8% of those with fracture.
Conclusion: Patients with a fracture involving the orbit and a rupture open globe injury have a worse visual prognosis compared to those patients with only a rupture open globe. In patients with an orbital fracture and a rupture open globe, visual acuity is less likely to improve, and the eye is more likely to be enucleated.