Fractures of the Orbit in Children

What are fractures of the orbit in children?

An orbital fracture happens when one or more bones around one of your child's eyes is broken. The orbit is the bony structure around the eye. This bony cavity contains the eyeball, muscles, nerves, and blood vessels.

What causes a fracture of the orbit in a child?

This condition often happens after blunt injury. Depending on where the fracture is located, it can cause severe eye injury and damage.

Which children are at risk for an orbital fracture?

This type of fracture is more likely in teen and young adult males who play certain sports. These include baseball and softball.

What are the symptoms of an orbital fracture in a child?

Symptoms can be different from one child to another. They can include:

• Eyelid swelling

• Bruising around the eye

• Eye pain

• Double vision

• Decreased eye movement

The symptoms of this condition may seem like symptoms of other conditions. Have your child see their healthcare provider for a diagnosis.

How is an orbital fracture diagnosed in a child?

Your child’s healthcare provider will do an exam and ask you about your child’s health history. Your child may also need the following tests:

• X-ray. This test shows images of internal tissues, bones, and organs.

• CT scan. A CT scan shows detailed images of any part of the body. This test will show your child’s bones, muscles, fat, and organs. CT scans are more detailed than X-rays alone.

How is an orbital fracture treated in a child?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is. Your child’s treatment may include the following.

Meeting with an eye care provider (ophthalmologist)

Your child’s eye care provider will do a complete evaluation of your child’s eye. Injuries that threaten your child's ability to see must be immediately identified and treated.

Waiting

Some fractures don’t have to be treated right away. Your child’s eye care provider may suggest waiting until the swelling and bruising go away before treating it. Double vision may go away on its own in a few days.

Your healthcare provider may give you specific instructions while you wait. Generally, parents are instructed to:

• Place ice or a cold pack on the injury for 20 minutes every 3 to 4 hours to limit swelling and pain. Wrap the ice or cold pack in a thin towel before putting it on the skin to prevent cold injury to the skin.

• If prescribed by your healthcare provider, use a decongestant to aid in the drainage of blood and fluid.

• Avoid nose blowing and sniffing.

• Keep the head elevated above the heart to help decrease swelling.

• Your healthcare provider may suggest over-the counter (OTC) medicine to help control pain. Ask your provider what medicines are safe for your child.

Surgery

If your child has a severe fracture, they may need surgery. Your child may also need surgery if the fracture affects their eye. Your child may have surgery right away or several days after they get hurt.

What are possible complications of an orbital fracture in a child?

Orbital fractures may cause serious eye injuries. These are medical emergencies that need to be looked at and treated right away.

Key points about orbital fractures in children

• An orbital fracture happens when one or more bones around the eye are broken.

• The condition often happens after blunt injury. It’s most common in teen and young males who play baseball or softball.

• Your child will need to meet with an eye care provider for a complete eye evaluation.

• If your child has a severe fracture, they may need surgery. Your child may also need surgery if the fracture affects the eye.

• Orbital fractures may cause serious eye injuries. These need emergency treatment.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.

• Before your visit, write down questions you want answered.

• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your healthcare provider gives you for your child.

• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are and when they should be reported.

• Ask if your child’s condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if your child does not take the medicine or have the test or procedure.

• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your child’s healthcare provider after office hours, and on weekends and holidays. This is important if your child becomes ill and you have questions or need advice.