Broken bones and blind eyes: Ocular and orbital injuries in craniofacial trauma

Aim: to describe ocular,neuro-ophthalmological and imaging patterns of head trauma,with special reference to road traffic accidents (rta) in an urban area of pakistan. study design: descriptive,retrospective study. study period: 2007 to 2013 subjects and settings: 42 patients of cranio facial trauma from three different centers of lahore were included in the study. history charts and neuro-imaging reports were reviewed. the data considered for the study was age,sex,ocular manifestations,neuro-ophthalmological findings and imaging reports results: male to female ratio was 6: 1. craniofacial injuries were common in patients of ≤ 40 years of age. the commonest cause of trauma was road traffic accidents (rta). 9 patients had severe vision loss (npl= no perception of light). 50% patients (n=21) had left sided trauma. 5(11.9%) were normal with no clinical and neuro-imaging findings. congested eyes,decreased vision,muscle entrapment in orbital fracture and restricted extra ocular movements due to severe edema were common ocular findings. other clinical signs were enophthalmos,hyphema,intra ocular foreign body,ocular motor nerve palsies,papilledema,retinal detachment,ruptured globe,traumatic optic neuropathy,vitreous hemorrhage,carotico-cavernous fistula and chiasmal damage. conclusion: in urban areas,rta account for maximum ocular injuries secondary to craniofacial trauma. proper and prompt actions in emergency department by multidisciplinary experts can not only save lives but also vision.