Converse : Chapter 25 Orbital and Naso - Orbital Fractures

Prior to the primary treatment of the fracture, an ophthalmologic examination should be done routinely to verify visual acuity and check the possibility of intraocular or corneal injury. Obviously, if the patient is unconscious, the examination is limited. In the conscious patient, a delay of the operative procedure for a few days will allow the edema to subside and permit a more thorough examination. Facial bone fractures are not surgical emergencies unless the airway is obstructed and a tracheotomy is indicated. Treatment of an orbital fracture should not be delayed more than necessary, however, as fibrosis of the entrapped extraocular musculature, loss of orbital fat, and organization of the fracture occur rapidly and complicate the treatment.