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February 1989

Intraocular Pressure as an Index of Ocular Injury in Orbital Fractures

Author Affiliations

From the Department of Otolaryngology–Head and Neck Surgery, University of Washington, Seattle.

Arch Otolaryngol Head Neck Surg. 1989;115(2):213-216. doi:10.1001/archotol.1989.01860260087020

• An improved method of screening for ocular injuries in patients sustaining orbital fractures is proposed. We performed a retrospective study of 107 patients who sustained orbital fractures. Intraocular pressures were measured on presentation in 17 patients and were found to be elevated on the side of the injury in eight patients, five (63%) of whom had significant ocular injury. No patient with normal intraocular pressure was found to have an ocular injury. In a prospective study, the intraocular pressures of 30 patients sustaining orbital fractures were measured. Twelve patients (40%) had normal (<22 mm Hg) and bilaterally symmetric (<3 mm Hg difference) intraocular pressures. One (8%) of these patients sustained ocular injury. In contrast, 18 patients (60%) had either an elevated intraocular pressure (>22 mm Hg) or a difference between eyes of greater than or equal to 3 mm Hg. Eleven (61%) of these patients were found to have sustained an ocular injury. We conclude that intraocular hypertension or significant interocular pressure differences should alert the physician to a potential ocular injury.

(Arch Otolaryngol Head Neck Surg 1989;115:213-216)