Patient - 3
Orbital floor fracture is common with facial trauma as may occur with a history or fall or road traffic accidents.
Patients may suffer from double vision in up gaze, inward position of the eye, or even nausea/vomitting in case the muscle below the eye is trapped in fracture fragments.
Not all orbital fractures require surgical correction!
A detailed and early evaluation with an Oculoplastic surgeon can help assess the need for observation versus need for surgery.
The patient below had a fracture of the orbital floor that led to entrapment of the inferior rectus muscle sheath that lead to double vision in up-gaze along with vomitting.
We intervened early to release the entrapped muscle surgically.
The surgery was performed through a transconjunctival approach, and since the defect was linear with insignificant volume loss, a biodegradable flexible absorbable implant was placed.
A week after surgery, the patient was taught some eye movement exercises to alleviate her of the double vision, which improved significantly every week, as the muscle swelling reduced. Three weeks after surgery, patient regained full range of eye movements.
The best part of this approach to surgery is that: 1. No skin incision or scar! 2. No skin sutures!
Contact UsPatient - 5
This child was brought with history of a blouse hook injury following which the grandmother noted a few drops of blood tinged tears. The skin showed a mild tear. They consulted locally where they were reassured.
The grandmother though was not convinced and came to us for a second opinion during which we made note of the lower canalicular tear.
A canalicular tear to be repaired earliest possible, else the pathway may be very difficult to find. there is a risk of lifelong watering of the eye in some patients even if one of the two canaliculi are blocked.
Under general anesthesia, the child’s injury and eye were examined in detail. The canaliculus was secured with a minimonoka tube (blue arrow) and the tear was sutured with absorbable sutures.
After 3 months the tube was pulled out in the opd and the child did very well with no episodes of watering.
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