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  • Chris Thiagarajah MD

Orbital Fracture from a ski injury: What my skiing patients in Vail Should know



In my career I have several times had patients who suffered an orbital fracture injury while skiing or snowboarding. Often when there is injury to the orbit or eye socket, a patient is unsure what to do and when to do it. This is an article discussing orbital fracture surgery and the most common questions patients have.

What is the first priority if I suffer a fracture of my eye socket?

The first overall priority in a patient who has an orbital fracture is to get their eyes examined. If you think about it, if a patient suffers an injury to their eye socket where the bones of the eye socket break, there must have been a significant force for that to happen. If that does happen, it is possible for the eye to get damaged as well. In the ER at the hospital after discharge, try to get in with an eye doctor to dilate your eye and check out your retina and your eye pressure. This is very important.

What is the second priority if I suffer a fracture of my eye socket?

The second priority is to see an eye socket specialist. As an oculoplastic surgeon we evaluate and treat eye socket or orbital fractures. One has to look at eye muscle movement, how big the fracture is and the need for eye socket fracture repair. Not all fractures need to be repaired so it is critical to see someone who can advise if you do or do not need surgery.

When should someone get eye socket or orbital fracture surgery?

There are several indications for eye socket fracture surgery. First if someone has a large fracture, the eye can be sinking into the eye socket (also called enophthalmos). Second, if a patient has double vision when looking straight ahead that is another indication for fixing the fracture. This is especially true if a muscle is trapped in the bone. Repairing the fracture does not guarantee that things will go back to normal but if the muscle is trapped, it will not get better if it is just left and stuck in the bone.

When are not indications for a patient to get orbital fracture surgery?

Small Fractures with no double vision – small fractures without double vision do not need surgery and will heal on their own. We try not to operate on these patients as any orbital surgery carries the risk of vision loss and double vision.

Numbness of the cheek – numbness of the cheek is not an indication to repair an orbital fracture. The numbness tends to get better on its own but if the nerve is severely damaged the sensation may not return.

Painful socket – Pain in the eye socket is not an indication for surgery either. Usually the pain gets better with time. If there is significant nerve damage, pain may improve. Certainly surgery is not going to improve pain and only risks the chance of increasing it.

How soon should I get orbital fracture surgery?

I recommend to patients to try to get surgery as soon as they can. There are limitations such as scheduling, insurance and availability of the surgeon. At the least, they should get examined by an oculoplastic surgeon as soon as they can.


How do I schedule a consultation for orbital or eye socket fracture?

The best thing is to call our office 303 468 8844.


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