The middle third of the face is the most common site of injury and is frequently complicated by associated ocular injuries. It may be simple laceration, ecchymosis, circumorbital edema, or severe as globe injury or injury to the optic nerve and vision loss. Even severe injury like internal bleeding causes increased intraocular pressure and damages the optic nerve; if managed earlier, it could prevent further damage and dysfunction of the eye. Midfacial fractures associated with ocular injuries should have an early ophthalmological examination to detect ocular injuries. Little is known about the current epidemiology of midface fractures and associated ocular injuries in Tamil Nadu, the state of India. The aim was to study the etiology and pattern of middle third fracture and associated ocular injuries.

This prospective study on midface fractures was carried out in the Department of Dentistry to analyze etiology, incidence, and patterns of midface fractures and associated ocular injuries. A total of 201 patients who reported with the history of midface injuries were included in the study. These patients were examined clinically and routine radiographs and computerized tomography magnetic resonance imaging (MRI) were taken to confirm the diagnosis. All the patients sustaining confirmed middle third fractures with or without eye signs were referred to an ophthalmology department for the evaluation and management of associated ophthalmic injury. Statistical Package for the Social Sciences software version 16.0 was used for data analysis. The outcome of the study was measured using percentages, mean, standard deviation, and test of proportion as appropriate.

Traffic accident was the major cause of injury, mainly by motorized two wheelers (MTWs). Males in the 21 to 40 age group were common victims. Zygomatic complex fracture was the most common fracture type. Subconjunctival hemorrhage and infraorbital nerve injuries were common clinical findings.

Midthird facial injury cases should have an early ophthalmological examination for timely management to prevent dysfunction of the eye.

Mohanavalli S, Suma E, Senthamarai G, Vijayabala GS. Ocular Injuries in Association with Middle Third Facial Injuries in Developing Countries: A Prospective Study. World J Dent 2016;7(3):135-140.