Facial Fracture-Associated Blindness

J Craniofac Surg. 2018 May;29(3):751-753. doi: 10.1097/SCS.0000000000004378.

Abstract

Introduction: Yet uncommon, blindness is a potential associated injury of facial fractures.

Methods: Epidemiology, mechanisms, fracture types, and outcome of facial fractures-associated blindness in a 10-year period are retrospectively reviewed.

Results: Out of 907 facial fractures patients, 10 had blindness, giving a frequency of 1.1%. There were 9 men and 1 woman whom age range was 6 to 59 years (mean: 31.2 years). Intentional injury patients were significantly the most at risk of blindness (P = 0.02). In all the patients, the fracture involved at least 1 of the orbit walls. Risk of blindness was significantly higher in naso-fronto-orbito-ethmoidal complex fractures (P = 0.03). The vision loss was recorded in 13 eyes (unilateral in 7 patients and bilateral in 3). Its predominant mechanism was a globe rupture or perforation, recorded in 8 eyes. A treatment with intention to improve the vision was attempted in 1 patient only. None of the patients had vision recovery.

Discussion: The findings of this study commend comprehensive ophthalmologic evaluation in any patient with an orbit wall fracture.

MeSH terms

  • Adolescent
  • Adult
  • Blindness / epidemiology
  • Blindness / etiology*
  • Child
  • Eye Injuries / complications
  • Eye Injuries / etiology
  • Facial Bones / injuries*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Orbital Fractures / complications
  • Orbital Fractures / epidemiology
  • Retrospective Studies
  • Skull Fractures / complications*
  • Skull Fractures / epidemiology
  • Vision Disorders / etiology
  • Young Adult