Blindness after facial trauma: epidemiology, incidence and risk factors. a 27-year cohort study of 5708 patients.

Publication date: Available online 23 March 2018
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Panagiotis Stathopoulos, Dimosthenis Igoumenakis, Michalis Mezitis, George Rallis
ObjectivesThis is a 27-year study of a cohort of 5708 patients who sustained maxillofacial fractures. Our purpose is to present the aetiology, mechanism of trauma, site and concomitant injuries that led to visual loss. We hypothesize that fractures caused by high energy impact of the midface may be associated with blindness. A discussion of the treatment approaches is also included.Study Design5708 patients sustained a maxillofacial fracture during the years from 1985 to 2012 and were included in this study. Patients' records were reviewed for gender, age, fracture site, aetiology of trauma, concomitant injuries, method of treatment, length of hospital stay and cause of blindness. The relation of the above variables to blindness was investigated.ResultsThe incidence of loss of vision was 0.34%. A very strong association between firearm injuries and blindness is demonstrated. (p<0.001) These patients spent much longer time in hospital (p<0.01) and suffered serious concomitant injuries involving the brain.ConclusionRetrobullbar haemorrhage should be treated with lateral canthotomy whereas in traumatic optic neuropathy, observation seems to be the safest thing to do. In patients with penetrating injuries of the globe the immediate involvement of an Ophthalmic Surgeon is of paramount importance.



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