Blindness associated with midfacial fractures

Purpose: This study assessed the frequency of blindness associated with midfacial fractures and correlated this with the fracture pattern. Patients and Methods: A retrospective analysis of 49 patients admitted with midfacial fractures from January 1995 to March 1997 was performed to determine the presence of posttraumatic blindness. The medical and radiological records of the patients with blindness were reviewed for age and sex, cause of the injury, type of facial fracture, type of-ocular trauma, and probable cause of the blindness. Results: Ten of the 49 patients lost vision in one, eye (20% of all midfacial fractures and 22% of midface fractures involving the orbit). The possibility of blindness associated with facial fractures was directly related to the severity of injury. Road traffic accidents were the most common cause. Blindness was attributable to traumatic optic nerve injury in seven cases and a ruptured globe in three cases. Conclusions: The high frequency of blindness associated with midfacial fractures in this series was attributable to the predominance of road traffic accidents as the major cause and absence of an obligatory seat belt law. Early diagnosis of the exact nature of the ophthalmic injury and treatment are important, and involvement of the ophthalmologist is mandatory.