Toward Management Consensus for Diplopia in Blow-Out Fractures of the Orbit

Although making a decision for the need for surgical correction of diplopia in blow-out fracture is difficult, it is logical to assume that an effective approach for management of diplopia in this type of injury should consider more than one factor. These factors include a preoperative BSV score and of the level of tissue herniation. Recently, the authors published two papers based on 10 year retrospective data on the influence of both preoperative BSV score and orbital tissue herniation on diplopia outcome. It is possible, on the basis of these studies data, to provide a figure about the potential benefit of surgery. Surgical intervention would be more beneficial for cases with orbital muscle entrapment / muscle herniation with preoperative BSV score ≤60%. Conservative management might be considered for cases with BSV ≥80%. In the 60-80% BSV range, the level of tissue herniation may advise the need for surgical intervention.