Orbital fracture surgery, often called eye socket surgery, repairs the delicate bone structure surrounding the eyeball to restore its proper position and function. Trauma to the face can cause a break in the orbit, most commonly in the thin bone of the floor or inner wall, sometimes trapping the muscles or soft tissues that control eye movement. Surgery is typically necessary for larger fractures, persistent double vision, or when the eyeball has sunken into the socket. This procedure aims to reconstruct the orbit using materials like porous polyethylene or titanium mesh, providing a stable foundation for the eye.
Managing Initial Recovery Symptoms
Pain, swelling, and bruising are expected responses in the immediate post-operative period. Pain management usually involves prescription opioid medication for the first few days, followed by over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs). Patients should transition off stronger pain relievers within the first week and must not operate a vehicle while taking narcotic medication.
Swelling and bruising, often called a “black eye,” are most noticeable on the second or third day. Applying cold compresses and keeping the head elevated, even while sleeping, helps reduce fluid accumulation. This initial puffiness gradually subsides over the next one to two weeks.
Temporary visual changes are common due to residual swelling and tissue manipulation. Patients may experience blurred vision or double vision (diplopia) immediately after the operation, which usually resolves as the swelling decreases. Numbness in the cheek, upper lip, or teeth is also frequent because the sensory nerve runs through the orbital floor. This sensory change can take several weeks or even months to fully resolve.
If an incision was made, careful wound care is necessary to promote healing and prevent infection. The surgical site should be gently cleaned daily with mild soap and water, then patted dry. Antibiotics are often prescribed to minimize infection risk, especially since the orbit is close to the sinus cavities. Patients must complete the full course of prescribed antibiotics.
Long-Term Restrictions and Activity Timelines
Protection of the healing site requires specific physical restrictions in the weeks following surgery. Patients must strictly avoid blowing their nose forcefully for a minimum of 10 to 14 days, as this action can create pressure that forces air into the eye socket. Activities involving straining, heavy lifting, or bending over should also be avoided for at least one to two weeks, typically meaning no lifting more than 10 to 15 pounds.
A gradual return to exercise is necessary to prevent complications like bleeding (hematoma) or implant displacement. Light activities such as walking can typically be resumed within the first week, but more strenuous exercise must be avoided for approximately three weeks. Contact sports or activities that risk a blow to the face, such as basketball or soccer, require a much longer recovery, often needing clearance from the surgeon after six to eight weeks.
Driving is unsafe if the patient is still taking prescription pain medication or if they are experiencing any degree of double vision that impairs depth perception. Vision must be stable and clear before resuming driving. Patients should also avoid activities that involve rapid pressure changes, such as flying or deep-sea diving, for several weeks after the operation.
Most individuals can return to non-strenuous work or school within one week of the procedure. The eye area must be protected from any direct pressure. Patients should avoid rubbing the eye and take care with sleeping positions to prevent placing weight on the surgical site.
Recognizing Warning Signs and Follow-Up Care
While temporary symptoms are normal, certain signs indicate a potential complication that requires immediate medical attention. A sudden and severe loss of vision, or the abrupt onset or worsening of double vision that was not present before, should be reported immediately. Other urgent red flags include unmanageable pain that persists or increases despite prescribed medication, especially if it lasts longer than seven days.
Signs of infection, such as a fever, increasing redness or warmth around the incision site, or the discharge of pus, warrant an immediate call to the surgeon’s office. If numbness or tingling in the face begins to spread or worsens over time, medical staff must be notified quickly. Persistent, bright red bleeding from the nose that does not stop after applying ice and elevating the head is also a concern. These symptoms could indicate a problem with the graft, an infection, or a complication involving the optic nerve.
Regular follow-up appointments with the surgeon are essential for recovery. The typical schedule involves an initial visit one week after surgery for suture removal and a check of the surgical site. Subsequent appointments occur at four or six weeks, and then at three to six months. During these visits, the surgeon assesses the implant’s stability, checks eye movement, and monitors the resolution of any remaining double vision or numbness.