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Bilateral globe luxation with multiple facial fractures: what next?
  1. Deepsekhar Das,
  2. Avilasha Mohapatra,
  3. Sujeeth Modaboyina and
  4. Sahil Agrawal
  1. Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
  1. Correspondence to Dr Sahil Agrawal; agrawalsahil03.acad{at}gmail.com

Abstract

Luxation of the globe is a rare, vision-threatening event that can presently spontaneously or following trauma. A 35-year-old man presented with bilaterally luxated globe, postroad traffic accident. On imaging, bilateral LeFort fracture type 1, 2 and 3 with palatal split along with nasal bone and orbital floor fracture. Both condyles and left parasymphysis of mandible were fractured. There was no evidence of intracranial injury. There was pneumothorax on the right side for which intercostal drainage (ICD) tube was placed. On exploring, bilateral optic nerve avulsion was present. Both the globes were repositioned and a temporary tarsorrhaphy was placed for cosmetic rehabilitation. On follow-up visits after 6 months, both eyes were in their sockets with minimal exodeviation. It is important to reposition the globes, even with extensive periorbital fracture at the earliest. The longer the globe and orbital structures are prolapsed, the poorer are the structural and cosmetic prognosis owing to ocular ischaemia.

  • eye
  • trauma
  • accidents
  • injuries
  • ophthalmology
  • oral and maxillofacial surgery

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Footnotes

  • Contributors DD wrote the first draft and was the surgeon. AM helped in data collection and literature search. SM helped with editing and redrafting the finale version of the manuscript. SA did final approval and acts as a guarantor. He was the primary surgeon as well.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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