Delhi Journal of Ophthalmology

Multimodality Imaging in Mechanical Orbital Trauma

Ebinesh A, Alpana Manchanda, Radhika Batra, Apoorva Sehgal
Department Of Radiodiagnosis, Maulana Azad Medical College and associated hospitals, New Delhi India 

Editor-in-Chief, Delhi Journal of Ophthalmology, Dr R.P.Centre, AIIMS.

Corresponding Author:

Ebinesh A
Department Of Radiodiagnosis, Maulana Azad Medical College and Associated Hospitals, New Delhi, India. 

Received: 12-NOV-2021 Accepted: 16-JAN-2022 Published Online: 03-APR-2022

Orbital trauma is commonly associated with trauma to head and face and the radiologist plays a key role in assessing these injuries. Common forms of orbital injury include bony fractures, anterior chamber injuries, injuries to lens, open-globe injuries, ocular detachments, intra-orbital foreign bodies, carotico-cavernous fistula and optic nerve injuries with orbital fractures being the commonest. Radiographic examination has low sensitivity for soft tissue injuries and is rarely performed. Ultrasound (USG) can be used to evaluate intraocular injuries and foreign bodies, however has poor sensitivity for evaluating the bone and retrobulbar area. It is contraindicated in open globe injuries.  Computed tomography (CT) is the modality of choice for initial imaging in orbital trauma owing to its easy availability, high sensitivity for detection of orbital fractures, and improved sensitivity for evaluation of soft tissue injury and entrapment. Magnetic resonance imaging (MRI) may be difficult to perform in an emergency setting, has limited role in evaluating bony injuries and is contraindicated in cases of suspected intra-orbital metallic foreign body. However, owing to its higher soft tissue contrast resolution, it is indicated in optic nerve injuries, ocular detachments, carotico-cavernous fistula and particularly when contrast cannot be administered due to deranged renal function. 
This article provides a comprehensive account of the role of various imaging modalities in the evaluation of trauma to the orbit and ocular globe with their imaging features and clinical relevance. 

Keywords :Orbital Trauma, Imaging, Computed Tomography, Blow Out Fracture, Open Globe Injury, Intraocular Foreign Body