Ocular Injuries And Visual Outcomes Associated With Maxillo-Facial Trauma - An Observational Study

Abstract

Background: Maxillofacial trauma is a common global injury, often accompanied by ocular injuries due to the anatomical proximity of the face to the eye. Such trauma, frequently resulting from road traffic accidents, assaults, or falls, can lead to complications ranging from periorbital edema to severe vision-threatening conditions like globe rupture and optic nerve damage. Comprehensive management requires a multidisciplinary approach involving maxillofacial surgeons and ophthalmologists to prevent permanent visual impairment.

Method: This prospective observational study was conducted over 18 months at the Adichunchanagiri Institute of Medical Sciences, Karnataka. A total of 129 patients with maxillofacial injuries were recruited based on specific inclusion criteria. Detailed ophthalmologic examinations, including visual acuity tests, anterior and posterior segment evaluations, intraocular pressure measurements, and radiologic investigations such as CT scans, were performed. Data were analyzed statistically with SPSS software to assess ocular injury prevalence and visual outcomes.

Results:  Among the 129 patients (73.6% male, mean age 34.2 years), road traffic accidents were the leading cause of injury (62%). Zygomaticomaxillary complex (ZMC) fractures were most common (38.8%), followed by mandibular (27.1%), nasal (18.6%), and orbital fractures (11.6%). Ocular injuries included periorbital edema (50.3%) and subconjunctival hemorrhage (31%), with less frequent but severe injuries such as globe rupture (3.1%) and traumatic optic neuropathy (6.2%). Visual acuity improved over six months, with 58.1% of patients regaining near-normal vision (6/6 to 6/12). Severe irreversible visual loss persisted primarily in cases with globe rupture or optic nerve damage.

Conclusion:  The study underscores the significant association between midfacial fractures, particularly ZMC and orbital fractures, and ocular injuries. Early ophthalmologic assessment and a multidisciplinary approach are vital to optimize visual recovery and facial reconstruction. Preventive public health measures, including road safety and protective equipment use, are essential to reduce trauma incidence. Further studies with larger samples and longer follow-ups are warranted to evaluate long-term ocular outcomes.