Pattern of Ophthalmic Injuries in Patients With Maxillofacial Fractures at a Tertiary Care Centre in Central India.

Abstract

Introduction: Maxillofacial injuries are usually associated with ophthalmic injuries that may be mild to severe, and may even result in loss of integrity of the orbital skeleton and impairment of the visual apparatus.

Aim: To evaluate the pattern of ophthalmic injuries associated with maxillofacial fractures in patients who reported to a tertiary care hospital, associated with a medical college in M.P, India.

Material and methods: The records of patients who sustained ophthalmic injuries with maxillofacial trauma from 1st January 2012 to 31st January 2024 and reported to the Department of Dentistry of a tertiary care hospital were evaluated. The data related to demographic characteristics, aetiology of trauma, type of maxillofacial fractures and pattern of ophthalmic injuries were gathered and analysed.

Results: A total of 1575 patients with maxillofacial trauma reported to the institute during the study duration. The study sample comprised 1046 (66.41%) maxillofacial trauma patients who sustained ophthalmic injuries. Males were more commonly involved (85.85%) than females (14.15%). The commonly involved age group was 21-30 years with 34.32% of patients belonging to the age group. The most common aetiology was road traffic accidents, reported in 71.89% of patients. Zygomaticomaxillary complex (ZMC) fractures were evident in 73.52%, mandibular fractures in 50.19%, naso-orbito-ethmoidal (NOE) fractures in 19.41% and frontal bone fractures in 18.74% patients. Subconjunctival haemorrhage was seen in 79.83%, periorbital ecchymosis in 72.94% and periorbital oedema in 60.32% of cases. Retrobulbar haemorrhage was seen in 2.58%, traumatic optic neuropathy in 2.01% and retinal detachment in 0.86% of cases.

Conclusion: Ophthalmic injuries were seen frequently in 66.41% of cases with maxillofacial trauma, particularly in zygomatic complex fractures (73.52%). The findings emphasise that the competency of maxillofacial surgeons plays a vital role in comprehending the severity and management of post-traumatic ophthalmic consequences in maxillofacial injuries. Also, ophthalmological evaluation in maxillofacial trauma, particularly involving the midface should be considered mandatory.