Orbital Fractures

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What is this information about?

This leaflet is for people with a suspected or confirmed orbital fracture (a break in the bone around the eye).  

It explains what the injury is, what symptoms to look out for, how you will be tested, and how you will be treated. 

Why have I been given this leaflet?

You’ve been seen in hospital and may have an injury to the bone around your eye. This leaflet gives guidance while you wait for follow-up or further treatment. 

What is an orbital fracture?

The orbit is the bony socket that holds your eye in place. 
If one or more of the bones in this socket are broken, it is called an orbital fracture. 

What causes an orbital fracture?

Orbital fractures are usually caused by: 

• road traffic accidents 
• assaults 
• falls 
• sports injuries 
• accidents at work

You can help prevent these by wearing seatbelts and using protective eyewear during contact sports or at work. 

What are the signs and symptoms?

Signs and symptoms vary depending on how the injury happened and how severe it is. 
Commonly experienced problems are: 

• Pain. Around the eye and face, especially when moving the eye. 
• Double vision. Eye muscles may be trapped or swollen, stopping both eyes from moving together. 
• Blurred vision. Damage to the eye’s surface or nerve can cause blurred sight. 
• Loss of feeling. Numbness in the cheek, lip, teeth, or forehead if a nerve is affected. 
• Bruising. A black eye, or red patches on the white part of the eye or eyelid. 
• Puffy eyelids. Trapped air under the skin can cause swelling, especially if a sinus wall is broken. 
• Sunken eye. The eye may look lower or pushed back if soft tissue moves into the sinus space. 

How will my injury be tested?

Testing usually involves more than one department. You may need a few different checks. 

• The Maxillofacial Team

They specialise in face and jaw injuries. 
They organise scans and plan your treatment, including surgery if needed.

• Radiology Department

You may need a CT scan or MRI scan. 
These show broken bones or damage to soft tissue around the eye. 

• Eye Clinic (Ophthalmology) 

If you have vision problems or a visible eye injury, an eye doctor will examine your eyes. 
They will check for scratches, bleeding, infection, or damage inside the eye. 

• Orthoptist 

If you’re seeing double, a specialist in eye movement will test how well your eyes move and work together. 

How will my injury be treated?

Treatment depends on how serious the injury is.

Mild injury (no surgery needed): 

• painkillers 
• cold compress for swelling 
• rest for a few days 
• do not blow your nose while healing 

Severe injury (surgery needed quickly): 

Surgery may be needed within 4 days, especially if:

• a muscle is trapped 
• you feel sick or have a low heart rate (mainly in children) 
• eye movement is badly affected 

Delayed surgery (after swelling reduces): 

Sometimes doctors wait 1 week for the swelling to go down. 
They may then reassess and plan surgery if needed. 

What if I need surgery?

You might need surgery if: 

• bone pieces need to be removed 
• muscle or tissue is trapped 
• your eye is out of position 
• you still have double vision 

Surgery depends on the location of the fracture, your age, and other injuries. 
Your surgeon will explain the risks and benefits. 

After surgery, if double vision continues, an orthoptic reassessment may be arranged. Prisms or an eye patch can help manage this. 

Should I blow my nose?

No.

Blowing your nose can push air into the skin around your eye and make the swelling worse. Avoid blowing your nose while healing. 

Where can I get more help or information?

• Visit the NHS website: www.nhs.uk 
• Call NHS 111 or go to 111.nhs.uk 
• Speak to your GP or the hospital team caring for you 
• You may be seen again in the Maxillofacial Clinic, Eye Clinic, or Orthoptic Team

Orthoptist – Contact Numbers