The bones around the eye often take the force of an impact to the orbit. If there is a suspicion of a fracture to the bones of the orbit, facial X-rays can be taken, however these frequently miss fractures. A CT of the orbit is the definitive way to diagnose orbital fractures
If an orbital fracture is suspected please discuss the case with maxillofacial surgeons and the on-call ophthalmologist. Instruct the patient not to blow their nose.
See factors to access below.
Factors to assess in these cases are:
This will help triage the urgency of referral when discussing with secondary care.
Discuss with maxillofacial surgeons an the BEH on-call opthalmologist.
These guidelines have been written by Rhys Harrison, consultant ophthalmologist at Bristol Eye Hospital, with thanks to the patients who have kindly given consent to use their photos.
For full ophthalmology guidelines see: Primary Care Ophthalmology Guidance Document
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