TRAUMA (ORBITAL FRACTURES, EYELID LACERATIONS)
Trauma to the eyelids and orbit (eye socket) should be examined thoroughly by an ophthalmologist and oculofacial plastic surgeon. The eye itself is often involved in this type of facial trauma, so a careful eye examination should be performed as soon as possible after the injury.
Trauma to the eyelids may result in lacerations that affect the entire thickness of the eyelid margin (where the lashes are located), and the tear duct system. Inadequate surgical intervention for these types of injuries may result in eyelid deformity, incomplete eyelid closure, or tearing problems. Dr. Yogita Kashyap, an oculofacial plastic surgeon, has extensive training to treat these injuries and ensure proper healing. Eyelid lacerations may often be surgically reconstructed in the office under local anesthesia. More complex eyelid trauma, especially when involving the tear duct system, may require reconstruction in the operating room under sedation.
Blunt trauma to the eye may result in a fracture of the socket, also known as an orbital fracture. The most common type is a fracture of the wall located between the eye and the nose, known as a “blow-out” fracture. This injury results in a condition called enophthalmos – sinking of the orbital contents through the bony defect. Orbital fracture repair is prevent this, but If enophthalmos is already present, orbital reconstruction may be performed to move the eye back into a normal position.
Approximately only 50% of orbital fractures require surgical repair.
The decision to complete a fracture repair surgery depends on the appearance of the injury in a CT scan and the clinical examination. Treatment generally involves making an incision behind the eyelid, which spares the skin and prevents scarring. Once the fracture is located, a piece of titanium mesh (sometimes combined with a biocompatable material called Medpor) is placed over it . The surgery is performed under general anesthesia, and patients may expect to go home the same day.