Orbital Fracture in Children
Medically reviewed by Drugs.com. Last updated on May 6, 2024.
What is an orbital fracture?
An orbital fracture is a break in one or more of the bones around your child's eye. Orbital fractures are caused by a hard blow to the eye area. Car accidents and sports injuries are the most common causes.
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What are the types of orbital fractures?
- A blowout fracture is a break in the eye socket along the floor or inner wall near the nose.
- An orbital rim fracture is a break in the eye socket along the outer edge.
- An orbital floor fracture is when the bones around the eye are pushed back. This causes the bottom, or floor, of the eye socket to buckle downward.
- A compound fracture is a blow to the middle of your child's face that causes a combination of fractures. These may include breaks to the orbital rim, floor, and cheek. This type of fracture may affect the eye socket and the cheek, nose, or jaw.
What are the signs and symptoms of an orbital fracture?
Signs and symptoms depend on the type of fracture. Your child may have any of the following:
- Pain and bruising around the eye
- Swelling of the forehead, cheek, or area around the eye
- Pain or trouble when your child moves his or her eye
- Double, blurry, or decreased vision
- Numbness
- Blood in the white part of your child's eye
- An eye that bulges or sinks
How is an orbital fracture diagnosed?
- Your child's healthcare provider or ophthalmologist will ask about the injury and examine your child's eye. Your child's provider will check your child's eye movement. The provider will also measure the position of your child's eye in the socket. Tell the provider if your child says his or her vision is blurry.
- An x-ray or CT may show an orbital bone fracture or foreign objects in your child's eye. Your child may be given contrast liquid to help the eye show up better in the pictures. Tell the healthcare provider if your child has ever had an allergic reaction to contrast liquid.
How is an orbital fracture treated?
Your child's provider may want to wait until the swelling decreases to decide if surgery is necessary. Minor fractures may not need surgery. Your child may need any of the following:
- Medicines:
- Decongestants can help decrease sinus pressure or congestion. This can help relieve pressure on your child's eye.
- Antibiotics may be prescribed to help prevent an infection.
- Steroids may be needed to decrease swelling.
- Acetaminophen decreases pain and fever. It is available without a doctor's order. Ask how much to give your child and how often to give it. Follow directions. Read the labels of all other medicines your child uses to see if they also contain acetaminophen, or ask your child's doctor or pharmacist. Acetaminophen can cause liver damage if not taken correctly.
- Do not give aspirin to children younger than 18 years. Your child could develop Reye syndrome if he or she has the flu or a fever and takes aspirin. Reye syndrome can cause life-threatening brain and liver damage. Check your child's medicine labels for aspirin or salicylates.
- NSAIDs , such as ibuprofen, help decrease swelling, pain, and fever. This medicine is available with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If your child takes blood thinner medicine, always ask if NSAIDs are safe for him or her. Always read the medicine label and follow directions. Do not give these medicines to children younger than 6 months without direction from a healthcare provider.
- Surgery may be needed if your child has decreased movement and function of the eye. Surgery may also be needed if the eye needs to be repositioned in the socket.
How can I help my child's eye heal?
- Apply ice on your child's injured eye for 15 to 20 minutes every hour or as directed. Use an ice pack, or put crushed ice in a plastic bag. Cover it with a towel before you apply it to your child's eye. Ice helps prevent tissue damage and decreases swelling and pain.
- Remind your child to not blow his or her nose until the fracture has healed, or as directed. Blowing the nose can put pressure on your child's eye socket.
- Remind your child to try not to sneeze. Your child should sneeze with his or her mouth open if necessary. This will help decrease pressure on his or her eye.
- Do not let your child use a straw until his or her fracture has healed. Straws can increase the pressure in your child's face and eye socket.
How can I help my child prevent an orbital fracture?
Have your child wear protective eyewear during sports. This can prevent eye injury. Make sure the eyewear wraps around the sides of your child's face. Do not use regular eyeglasses for eye protection. They will not protect your child's eyes from injury.
When should I seek immediate care?
- Your child's vision starts to blur.
- Your child says he or she starts to see double.
- Your child suddenly loses his or her vision.
- Your child has severe eye pain.
When should I call my child's doctor?
- Your child has a fever.
- Your child's symptoms do not go away, or they get worse.
- You have questions or concerns about your child's condition or care.
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