An eye socket fracture, also known as an orbital fracture, involves a break in one or more of the bones that form the protective cavity around your eyeball. This bony structure, called the orbit, encases the eye, its muscles, nerves, blood vessels, and fatty tissue. Such an injury is serious and requires prompt medical attention due to the potential for vision impairment and other complications.
Recognizing the Indicators
Pain around the eye, particularly with movement, often signals a potential eye socket fracture. Swelling and bruising, commonly appearing as a “black eye,” develop as blood pools under the skin around the orbit.
Double vision, or diplopia, is a common symptom. It can occur if eye muscles or soft tissues become trapped in the fracture, preventing the eyes from moving in a synchronized manner. Blurred vision or decreased vision may also be present, potentially indicating damage directly to the eyeball itself.
Numbness in the cheek, upper lip, or teeth on the affected side can occur if nerves, such as the infraorbital nerve, are damaged by the fracture. This nerve provides sensation to those areas. Difficulty moving the eye, especially looking up or down, is another indicator, often resulting from muscle entrapment within the fractured bone. A sunken appearance of the eye, medically termed enophthalmos, can develop if orbital tissue shifts into adjacent sinuses through the fracture, leading to a loss of support for the eyeball.
Bleeding from the eye or nose, including blood in the white part of the eye (subconjunctival hemorrhage), may also be observed. Changes in the shape of the eye or face, such as a flattened cheek or an irregular orbital rim, can be visible signs of a significant fracture. Puffy eyelids can also occur if air from the sinuses enters the skin tissue through a broken bone.
Immediate Steps to Take
If an eye socket fracture is suspected, seeking immediate medical attention is essential. Emergency care or an urgent care facility can provide the necessary professional evaluation. Prompt assessment helps determine the severity of the injury and guides appropriate next steps.
It is important to avoid rubbing or applying any direct pressure to the injured eye. Doing so could worsen the fracture or cause further damage to the delicate structures within the orbit. Instead, gently apply a cold compress around the eye to help reduce swelling and discomfort. Ensure the compress does not press directly on the eyeball.
Elevating the head can also help minimize swelling by promoting fluid drainage from the injured area. This simple measure can contribute to comfort while awaiting medical assessment. A person with a suspected eye socket fracture should avoid blowing their nose. Blowing the nose can force air from the sinuses into the tissues around the eye, potentially increasing swelling and introducing bacteria.
Self-diagnosis is not sufficient for an injury of this nature. A medical professional must evaluate the eye and surrounding area thoroughly to confirm a fracture and identify any associated injuries. This professional assessment is essential for preventing potential long-term complications.
Confirming the Diagnosis
Medical professionals confirm an eye socket fracture through a combination of physical examination and imaging tests. An ophthalmologist or emergency physician will carefully examine the eye and the surrounding facial area. This examination includes checking eye movement, assessing vision, and testing sensation in areas like the cheek, upper lip, and teeth. They may also check for signs like a sunken eyeball or any asymmetry in the facial structure.
Imaging tests are essential for visualizing the bones of the orbit and confirming a fracture. A Computed Tomography (CT) scan is the most common and effective method used for diagnosing orbital fractures. CT scans provide detailed cross-sectional images that clearly show bone fractures, the extent of displacement, and whether any soft tissues or muscles are trapped. These scans can also help identify other potential injuries within the eye or surrounding areas.
While CT scans are the primary diagnostic tool, X-rays might be used as an initial step in some cases. However, X-rays offer less detail than CT scans and may not fully reveal the extent of an orbital fracture or associated soft tissue damage. In specific circumstances, other tests might be conducted to check for additional eye injuries, such as damage to the optic nerve or other structures within the eyeball.