Ocular Injuries in Association with Middle Third Facial Injuries in Developing Countries: A Prospective Study

Abstract

Introduction:The middle third of the face is the most common site of injury and is frequently complicated by associated ocular injuries. It may be simple laceration, ecchymosis, circumorbital edema, or severe as globe injury or injury to the optic nerve and vision loss. Even severe injury like internal bleeding causes increased intraocular pressure and damages the optic nerve; if managed earlier, it could prevent further damage and dysfunction of the eye. Midfacial fractures associated with ocular injuries should have an early ophthalmological examination to detect ocular injuries. Little is known about the current epidemiology of midface fractures and associated ocular injuries in Tamil Nadu, the state of India. The aim was to study the etiology and pattern of middle third fracture and associated ocular injuries.

Pattern of ocular involvement in midface injuries seen at a tertiary care hospital in northern Nigeria

“…This is similar but much higher than other reports where between 43.3% and 77.0% of midfacial injuries were due to RTAs. [ 7 9 10 11 ] While the second most common etiology in our study was assault or interpersonal violence (IPV) (4.7%), followed by animal injury (2%) and falls (1.3%) [ Table 1 ], most other studies[ 7 9 10 11 ] reported falls (23.5%–32.0%), followed by IPV (6.9%–21.0%).…”

“…This agreed with most reports on ocular injuries associated with midfacial injuries. [ 6 10 11 ] However, Politis et al . [ 11 ] found the 41–50 years' age bracket as most affected (18.9%) in a Belgian study.…”

“…Other workers did not distinguish soft-tissue injuries from fractures for comparison. In the midface, fractures of zygomatic complex (62.0%), followed by Le Fort II (27.0%) and orbital wall fractures (13.9%), were the most common causes of ocular injuries, according to Mohanavalli et al .,[ 10 ] while Politis et al . [ 11 ] found that those of the maxillary sinus (44.3%), followed by those of the orbital walls (23.6%) and zygoma (23.6%), were the common causes of ocular injuries.…”

“…The proportion of subconjunctival hemorrhage in our study was much lower than 76.1%–83.5% found among Indian patients. [ 9 10 ] In their series, Politis et al . [ 11 ] found diplopia/restriction to eye movement (48.8%) as the most common ocular injury, followed by injuries to the globe and eyelid injuries (36% and 31.7%, respectively).…”

“…While road traffic accidents (RTAs) are the most frequent etiological factor for midfacial injuries in developing countries, in developed nations, assaults are the most frequent etiology. [ 9 10 ] In the midface, zygomatic complex fractures are most often associated with ocular injuries. [ 7 ] There are scant reports on ocular injuries associated with facial fractures, especially those of the midface, from developing countries.…”