Surgery on the extra-ocular muscles after orbital fracture.

We analyzed the files of 61 patients presenting with diplopia due to orbital fractures. Thirty-four patients needed a primary orbital reconstruction and this diminished the complaints of diplopia in most cases. In only 5 cases additional ocular surgery on the extra-ocular muscles was indicated. Of the 27 patients who did not require orbital surgery, 5 underwent extra-ocular muscle surgery to diminish diplopia. We present our guidelines for treatment, based on forced duction testing, ocular motility, primary position and field of binocular single vision.