Unfortunately, traumas are the reality of our daily lives. Trauma results can be observed in the eyelids, eye and orbit as well as in every part of the body. Traumas can be resulted from blunt, penetrating, cutting, firearm, and chemical ingredients. Ophthalmological emergencies are constituted by traumas to a significant extent.
Traumas in eyelids can be observed in a wide range from a slight lasering of the eyelids to fractures or piercing. All kinds of disfiguring injuries inside the eyelids should be intervened, and repair (reconstruction) should be performed in accordance with the eyelid anatomy. Patients should be informed that deformity may remain and in the future second and/or third surgical interventions may be needed.
If the anatomy of the tear ducts is distorted, a canalicular opening that led tears can pass must be obtained.
Image-1: Eyelid and orbital injuries
Secondary approaches may be needed for likely encountered things such as dropping of the eyelid, inward or outward turning of the free edge of the eyelid (ectoprium, entropium), and wound contraction.
Orbital injuries may happen for similar reasons. Often there is a combination of injury to the eyeball. Rarely, the optic nerve may also rupture (optic nerve avulsions). Serious conditions related to eye muscles can also be observed in patients. In these situations, surgical repair of anatomically damaged parts must be performed. Blow-aut fractures are a frequently encountered situation in orbital injuries. Because of blunt traumas on the cheek, the lower orbital wall is broken with a sudden pressure change (blastic effect), and the orbital contents herniate into the maxillary sinus. This leads orbit to move backward (enoftalmus), and diplopia, sense defects in the lower eyelid and cheeks happens.
If there is enophthalmos larger than 2 mm, diplopia, soft tissue compression on the fracture line, there is definitely an indication of surgery. In the surgery, the orbital contents should be pushed from the sinus to the orbit and a metal plate should be placed between. If there are adjacent fracture edges in other bone fractures of the orbit, no intervention is required, but if split fracture edges are observed, they should be joined surgically.