Blunt trauma of the face resulting from a motor vehicle accident, an athletic injury, or as a result of a physical confrontation may precipitate soft tissue injuries and fractured eye socket. One of the most common areas to sustain broken facial bones involves the bones that surround the eye. The bones that make-up the eye socket are some of the thinnest and weakest bones of the face and therefore they are the most vulnerable to fracturing from the sudden impact of a fall, a golf ball or baseball injury, a motor vehicle accident or a punch. The “floor” of eye-socket (also called the “orbit”) is particularly susceptible to fracturing from a sudden rise in orbital pressure and buckling of the bones. The bones of the orbital floor “blowout” in a downward direction. The broken bones of the floor of the socket no longer act as scaffolding to support the eyeball and soft tissues that surround the eye. The eyeball, fat and muscle sink downward and settle backward. The eye usually appears smaller and the muscles that normally move the eyeball may become entrapped in the fracture- restricting eye movement. The limitation of eye movements commonly leads to double vision. During the initial consultation Dr. Kopelman will perform an in-depth eye examination to make sure you have not sustained collateral damage to the eye itself. A CT scan will be obtained to assess the extent of bone fractures.
Q: How are orbital fractures repaired?
A: For ten years Dr. Kopelman was an active member of the orbital trauma team at New York Eye and Ear Infirmary and for the past thirty years he has repaired hundreds of orbital and facial fractures with excellent outcomes. Prior to the procedure patients are comfortably sedated under general anesthesia. In most cases, Dr. Kopelman performs an incision through the conjunctiva on the inside the lower eyelid. He explores the floor of the eye socket to determine the full extent of damage and checks if any soft tissue is entrapped in the fractured bones. The depressed tissues are elevated. Dr. Kopelman then measures the size of the hole that was occurred as a result from the injury. He then inserts a thin custom sized plastic plate to cover over the depression. The lower eyelid incision is then closed with absorbable sutures. In most cases no sutures will be removed later.
Q: Will I need to take any medication following surgery?
A: Yes, your will be given topical antibiotic drops for your eye and prophylactic oral antibiotics to prevent an infection from occurring. An oral steroid will also be prescribed to accelerate the resolution of facial swelling.
Q:Will there be any restrictions in my daily activities following surgery?
A:Following surgery, Dr. Kopelman instructs the patient to stop smoking or blowing their nose for six weeks. This will prevent air or smoke from tracking up through your sinuses into your eye socket. Air entering your orbit can sometimes inflate the soft tissues surrounding your eye and can occasionally lead to infections or impair your vision. For similar reasons you should not fly for two weeks following surgery because a change in cabin pressure can also lead to orbital emphysema.
Q: Can I return to my exercise routine immediately?
A:You may shower and resume your daily activities within twenty –four hours following surgery. Dr. Kopelman recommends that you return to mild to moderate exercise within the first week following surgery. However, he believes that you should refrain from yoga, intense aerobic exercise or weight lifting where unusual amounts of pressure are exerted on the face or body. These intense workouts may lead to sudden post-operative bleeding that may compromise the final result.
First and foremost, Dr. Kopelman and his nursing team, want you to be safe and healthy. We don’t want you to experience anything that would slow down your recovery. We will follow your progress very closely and make minor adjustments if they are needed. Ultimately, the majority of the patients are very pleased with the functional and aesthetic restoration that was achieved.