Severe Traumatic Intraocular Injuries Related to Blowout Fractures

안와파열골절 환자에서 중증 외상성 안구내 손상 발생과 연관인자 분석

  • Shin, Jae Hoon (Department of Emergency Medicine, College of Medicine, Konyang University) ;
  • Lee, Mi Jin (Department of Emergency Medicine, College of Medicine, Konyang University) ;
  • Park, Seong Soo (Department of Emergency Medicine, College of Medicine, Konyang University) ;
  • Jeong, Won Joon (Department of Emergency Medicine, College of Medicine, Konyang University) ;
  • You, Yeon Ho (Department of Emergency Medicine, College of Medicine, Chungnam University)
  • 신재훈 (건양대학교 의과대학 응급의학교실) ;
  • 이미진 (건양대학교 의과대학 응급의학교실) ;
  • 박성수 (건양대학교 의과대학 응급의학교실) ;
  • 정원준 (건양대학교 의과대학 응급의학교실) ;
  • 유연호 (충남대학교 의학전문대학원 응급의학교실)
  • Received : 2009.05.06
  • Accepted : 2009.06.07
  • Published : 2009.06.30

Abstract

Purpose: Blunt trauma can cause a wide range of ocular injuries. This study was performed to describe the prevalence of severe intraocular injuries (SIOI) and their correlation with the severity of blunt orbital trauma. Methods: We retrospectively analyzed 117 eyes of 107 patients with orbital wall fractures who visited the emergency room at Konyang University Hospital from July 2006 to June 2008. Clinical features such as age, sex, causes of injury, revised trauma score (RTS), type of orbital wall fractures were recorded. The patients were divided into two groups: blowout fracture with severe intraocular injuries (SIOI) and blowout fracture without SIOI. We compared the clinical and the injury-related characteristics between two groups and analyzed the SIOS-related factors. Results: Among the 107 patients (117 eyes) with blowout fractures, 29 (27.1%) patients with 32 eyes (25.6%) had complicated severe intraocular injuries. Retrobulbar hemorrhage (14.5%), hyphema (13.7%), traumatic optic nerve injury (4.3%), and sustained loss of visual acuity (4.3%) were the most common SIOI disorders. A logistic regression analysis revealed that loss of visual acuity (odds ratio = 4.75) and eyeball motility disorder (odds ratio=7.61) were significantly associated with SIOS. Conclusion: We suggest that blowout fracture patients with loss of visual acuity or eyeball motility disorder are mostly likely to have severe intraocular injuries, so they need an ophthalmologic evaluation immediately.

Keywords

References

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