Ophthalmic aspects of orbital injury. A comprehensive diagnostic and management approach.

Improved prognosis for eye injuries sustained during facial trauma depends on early assessment and accurate diagnosis. The surgeon responsible for management of the orbital fracture(s) must perform an ocular assessment at the time of initial examination. Abnormalities found on the five-point assessment outlined herein should lead to urgent ophthalmic consultation. Fracture repair should not be undertaken until the results of consultation have been discussed with the ophthalmologist. Vision should be carefully monitored in the preoperative period because delayed optic neuropathy may occur. Similarly, vision should be followed regularly in the postoperative period after reduction of fractures of the orbital bones. Decreased postoperative vision should lead to immediate ocular assessment and early ophthalmologic consultation.