![]() The latter occurs in orbital floor fractures with involvement of the infraorbital nerve and altered sensation in its infraorbital region of distribution. Patients may also experience diplopia and numbness of the cheek on the affected side. Most common are periorbital swelling, pain on movement of the eye and subconjunctival haemorrhage. Orbital fractures can cause many symptoms. ![]() ![]() The optic canal is located medial to the apex of the orbit and transmits cranial nerve II (optic nerve) and the ophthalmic artery. The superior orbital fissure continues in a craniolateral direction from the inferior orbital fissure and contains cranial nerve III (oculomotor nerve), cranial nerve IV (trochlear nerve), branches of cranial nerve V (trigeminal nerve), cranial nerve VI (abducens nerve), sympathetic fibres from the cavernous plexus and superior ophthalmic vein and inferior ophthalmic vein. The infraorbital nerve divides the orbital floor in a sagittal direction and is a contributory factor for the thin floor medial to the nerve often being the first to fracture. In addition, the inferior ophthalmic vein, zygomatic nerve and parasympathetic fibres pass from the pterygopalatine ganglion through the inferior orbital fissure. The former lies in the orbital floor and contains the infraorbital nerve, infraorbital artery and infraorbital vein, which enter the maxillary bone anteriorly and exit through the infraorbital foramen. Two central features in the orbit are the inferior orbital fissure and the superior orbital fissure (Figure 1). The evidence base is a non-systematic search in PubMed as well as the authors' clinical experience. This article gives an overview of the anatomy, clinical presentation, examination, radiological findings and treatment of orbital fractures. Another name for these fractures is blowout fractures because they tend to displace away from the orbit. Orbital fractures occur either as a result of kinetic energy being transmitted from the bone surrounding the eye or as a result of increased pressure when the eyeball (ocular globe, referred to as globe from now on) presses into the orbit (5). Fractures in the lateral wall are often combined fractures involving the cheek bone. The mechanism of injury is usually blunt force trauma to the eye region, leading to fracture of the thin bone of the orbit, most commonly the floor and medial wall (3, 4). The fractures are usually categorised by anatomical location, such as orbital floor, orbital roof, lateral wall and medial wall fractures. Orbital fractures are fractures in the bones surrounding the eye socket (orbit), and the third most common type of facial fracture in adults and children (1, 2). This clinical review article looks at the key factors regarding orbital fractures. Surgical treatment of orbital fractures aims to reconstruct the bony anatomy and restore the orbit's original volume. The fractures can lead to significant functional impairment and cosmetic changes. Orbital fractures can occur as a result of direct trauma to the eye region or surrounding facial bones.
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