Amrith S, Saw S M, Lim T C, Lee T K
Singapore National Eye Centre, Singapore.
J Craniomaxillofac Surg. 2000 Jun;28(3):140-7. doi: 10.1054/jcms.2000.0138.
This is a retrospective descriptive case study which will look into the spectrum of ophthalmic involvement in cases with orbital and eye injuries after cranio-facial trauma and to analyse the visual and motility outcome.
One hundred and four cases with ophthalmic involvement after cranio-facial trauma that were referred to and seen in the eye department of a tertiary teaching hospital in Singapore between 1991-97 were included in the study.
The case records of 104 such patients were traced. The demographic data, the mode of injury, the type of fracture sustained and presence of serious eye injury were noted. The details about visual acuity, significant diplopia and enophthalmos at the first and last visits were charted. Presence of traumatic optic neuropathy including the type of treatment given was recorded.
There was a male preponderance (82%). The industrial accidents were 21%, only next to road traffic accidents, which constituted approximately 36.5%. The predominant types of fractures seen were blow-out orbital fractures, complex fractures comprising of Le-Fort II, III, panfacial and fronto-basilar skull fractures. Diplopia was the most common presenting feature (40%) with visual acuity disturbance (23% having <6/60) as the next most common finding. Traumatic optic neuropathy was seen in 20% of patients and serious eye injury was present in 9% of patients. The incidence of traumatic optic neuropathy was significantly higher (p<0.001) in patients with complex fractures and fronto-basilar fractures, as compared to the blow-out and zygomatico-maxillary fractures. Analysis of final results indicated 15% as having significant diplopia in one or more gazes and 12.5% as having a vision of <6/60.
Diplopia and visual acuity disturbances seem to be the most common ophthalmic presentations in cranio-facial trauma. A significant number of patients suffer from poor vision and significant diplopia despite treatment.
这是一项回顾性描述性病例研究，旨在探究颅面创伤后眼眶和眼部损伤病例中的眼科受累范围，并分析视力和眼球运动结果。
本研究纳入了1991年至1997年间转诊至新加坡一家三级教学医院眼科并接受诊治的104例颅面创伤后有眼科受累的病例。
追溯这104例患者的病例记录。记录人口统计学数据、损伤方式、所遭受的骨折类型以及严重眼损伤的存在情况。绘制首次和末次就诊时的视力、明显复视和眼球内陷的详细情况。记录创伤性视神经病变的存在情况，包括所给予的治疗类型。
男性占优势（82%）。工业事故占21%，仅次于道路交通事故，后者约占36.5%。所见的主要骨折类型为眼眶爆裂骨折、包括Le - Fort II、III型、全面部和额基底颅骨骨折的复杂骨折。复视是最常见的表现特征（40%），其次是视力障碍（23%视力<6/60）。20%的患者出现创伤性视神经病变，9%的患者存在严重眼损伤。与眼眶爆裂骨折和颧上颌骨折相比，复杂骨折和额基底骨折患者的创伤性视神经病变发生率显著更高（p<0.001）。最终结果分析表明，15%的患者在一个或多个注视方向存在明显复视，12.5%的患者视力<6/60。
复视和视力障碍似乎是颅面创伤中最常见的眼科表现。尽管接受了治疗，但仍有相当数量的患者视力不佳且存在明显复视。
