Abstract/Text: Eye trauma is frequently seen by non-ophthalmology providers. This article elucidates a methodological approach to eye trauma. The first step is to address any life-threatening conditions. Then a focused history and exam is discussed, starting externally. Then, key history, physical, pathophysiology, and basic management of common, serious eye injuries are discussed: chemical injury, orbital fractures, open globe, traumatic hyphema, retinal detachment, traumatic optic neuropathy, and eyelid laceration. Finally, we highlight the practicality of telemedicine for areas where ophthalmology coverage is lacking.

© Copyright 2021 by the American Board of Family Medicine.

Abstract/Text: Only based on a standardized terminology of ocular trauma terms, and using a very large number of injuries treated by a wide variety of ophthalmologists, could a reliable method be developed so that the functional outcome of a serious eye injury can be predicted with reasonable certainty. The authors used the databases of the United States and Hungarian Eye Injury Registries and, with a grant from the National Center for Injury Prevention at the Centers for Disease Control and Prevention, designed such a system.

Abstract/Text: Only based on a standardized terminology of ocular trauma terms, and using a very large number of injuries treated by a wide variety of ophthalmologists, could a reliable method be developed so that the functional outcome of a serious eye injury can be predicted with reasonable certainty. The authors used the databases of the United States and Hungarian Eye Injury Registries and, with a grant from the National Center for Injury Prevention at the Centers for Disease Control and Prevention, designed such a system.

Abstract/Text: PURPOSE: To assess the quality of information in the literature and suggest guidelines for repair of isolated orbital floor fractures.
CLINICAL RELEVANCE: Orbital floor fractures are a common result of orbital injury. Enophthalmos, diplopia resulting from extraocular muscle dysfunction, and infraorbital nerve hypesthesia may occur. The indications and timing for fracture repair are still controversial.
LITERATURE REVIEWED: A MEDLINE literature review was performed using PubMed. Articles published from 1983 to the present were retrieved using the key words, "orbital floor fracture, orbital trap-door fracture, and orbital blow-out fracture." Suggested indications and timing for repair of isolated orbital floor fractures were extracted from selected articles. Each recommendation was rated according to its importance in the care process and strength of evidence supporting the given recommendation.
RESULTS: No prospective randomized clinical trials on the treatment of orbital floor fractures have been performed. Despite this, most recommendations were rated as most important to patient care (A) and had strong support for treatment (level I).
CONCLUSIONS: The timing and treatment indications for orbital floor fractures are evolving. Nonresolving oculocardiac reflex, the "white-eyed" blowout fracture, and early enophthalmos or hypoglobus are indications for immediate surgical repair. Surgery within 2 weeks is recommended in cases of symptomatic diplopia with positive forced ductions and evidence of orbital soft tissue entrapment on computed tomography examination or large orbital floor fractures that may cause latent enophthalmos or hypo-ophthalmos.