The eye socket, or orbit, is a bony cavity designed to protect the eyeball and its associated structures. It is comprised of seven bones. A broken eye socket, or orbital fracture, occurs when one or more of these bones break. The appearance of a broken eye socket can vary depending on the fracture’s severity and specific location within the orbit. Understanding these signs is important for seeking medical attention.
Visual Signs of a Broken Eye Socket
Swelling and bruising are common initial signs of an orbital fracture. Swelling around the eye and eyelids is common, often leading to a “black eye” with dark discoloration. In some cases, bruising can appear around both eyes, known as “raccoon eyes,” even if only one socket is fractured, due to blood pooling.
The position of the eye can also change. The eye may appear sunken into the socket, a condition called enophthalmos, if enough tissue is lost or if the fracture causes the eye to shift backward. Less commonly, the eye might bulge outwards, depending on the fracture type and whether orbital contents have been displaced.
Eye movement can be restricted or painful following a fracture. The affected eye may not move fully in certain directions, or it might lag behind the uninjured eye when tracking objects. This limited mobility often indicates that eye muscles or surrounding tissues are trapped within the fracture site.
Bleeding within the eye is another visual sign. This can manifest as hyphema, visible blood collecting in the front chamber of the eye, or a bloodshot appearance in the white of the eye. A noticeable change in the shape of the face around the eye, such as a flattened cheekbone or an altered facial contour, can indicate a fracture, especially with severe injuries.
Accompanying Symptoms Beyond Visuals
Pain is a common symptom of a broken eye socket, localized around the eye and potentially worsening with eye movement, chewing, or touch. The intensity of this pain varies based on the fracture’s type and severity.
Double vision (diplopia) is a common symptom, often resulting from eye muscle entrapment or nerve damage within the fractured orbit. This happens when eyes cannot move synchronously, causing duplicated images.
Numbness, tingling, or altered sensation in the cheek, upper lip, or upper teeth on the injured side can indicate nerve involvement. This indicates potential nerve damage in the fractured area.
Fractures near the jaw joint can lead to difficulty or pain when opening the mouth. This occurs if the injury affects the bones or soft tissues involved in jaw movement. A nosebleed can also be an accompanying symptom, especially if the fracture extends into the adjacent sinus cavities. Nausea and vomiting may also occur, particularly with certain fractures like “trapdoor” fractures, where tissue becomes acutely entrapped.
Common Causes of Eye Socket Fractures
Eye socket fractures most frequently result from blunt force trauma directly to the eye or surrounding face. This typically involves an object hitting the face with significant force.
Sports injuries, such as being hit by a ball or an elbow, are common causes. Falls, motor vehicle accidents, physical assaults, and industrial accidents involving tools or heavy machinery also cause orbital fractures.
The mechanism of injury can vary. A direct impact to the strong outer orbital rim can cause a fracture there. Alternatively, a “blow-out” fracture occurs when pressure on the eyeball pushes the thin floor or inner wall of the orbit outwards into an adjacent sinus cavity. This indirect force can trap muscles and other soft tissues, leading to symptoms like restricted eye movement.
When to Seek Medical Attention
Immediate medical evaluation is recommended for any suspected eye socket injury. Consultation with an ophthalmologist or an oral and maxillofacial surgeon is important to assess the damage. Delays in seeking care can increase risks, including permanent vision impairment, persistent double vision, chronic pain, nerve damage, or cosmetic deformity.
A medical professional will conduct a thorough physical examination, assessing eye movement, vision, and eyeball position. Imaging tests, such as X-rays or computed tomography (CT) scans, are ordered to confirm the diagnosis and determine the location and severity of the fracture. CT scans are useful for visualizing fractures, blood collections, and displaced tissues.
While awaiting medical help, some initial self-care measures can be taken. Applying cold compresses to the injured area can help reduce swelling and discomfort. Over-the-counter pain relievers may also be used to manage pain, if appropriate. These measures are temporary and should not replace a medical assessment.