Zusammenfassung
Die Behandlung orbitaler Verletzungen gehört zum Alltag der medizinischen Akutversorgung. Bei 10 – 25% aller Gesichtsverletzungen ist die Orbita beteiligt. Dieser Beitrag gibt einen Überblick über die möglichen Pathologien nach Orbitatrauma sowie das primärdiagnostische Vorgehen und die therapeutischen Optionen.
Abstract
Orbital trauma is a common medical emergency with potentially sight-threatening complications. Due to the confined orbital conditions, any direct injury or space-consuming lesion may cause serious tissue damage. Possible complications are orbital fractures, foreign body injuries, development of orbital compartment syndrome and traumatic optic neuropathy. Clinical signs include periorbital hematoma or emphysema, subconjunctival hemorrhage, proptosis, decreased ocular mobility, decreased vision, increased intraocular pressure and relative afferent pupillary defect. Ophthalmic status and low-dose CT-imaging provide key information regarding the therapeutic decision. Treatment options include surgical exploration, reconstruction or decompression or a conservative approach with anti-inflammatory or anti-glaucomatous medication. Rapid interdisciplinary diagnostics and therapy is critical for early detection and prevention of irreversible functional loss respectively.
Considering the frequent association with life-threatening comorbidities diagnosis may be complicated.
Schlüsselwörter
Trauma der Orbita - orbitales Kompartmentsyndrom - orbitaler Fremdkörper - traumatische Optikusneuropathie
Key words
orbital trauma - orbital compartment syndrome - intraorbital foreign body - traumatic optic neuropathy