Is Ophthalmology Consult Needed for Acute Orbital Fractures?

Failure to recognize concomitant ocular injury in orbital fracture patients is a feared consequence of evaluation in the acute setting. These injuries and their accompanying functional sequelae range in severity, and reconstructive surgeons need to be sensitive to the possibility of major ocular injuries that could potentially have serious outcomes. Indications for specialty-trained ophthalmology evaluation in patients with orbital fractures remain controversial, with some advocating for an immediate and comprehensive evaluation of every patient with an orbital fracture. In many institutions, however, this may be difficult to achieve. Additionally, a reflexive emergent ophthalmologic consultation on every orbital fracture yields many normal examinations and therefore potentially places a great burden on the healthcare system. Current literature was reviewed to guide management of these injuries.