Quantitative evaluation of ocular motility in blow-out fractures for selection of nonsurgically managed cases.

Abstract

To clarify in which cases of blow-out fractures ocular motility will naturally recover. A retrospective review of observational cases. Involved ocular motility ranges were measured by the Hess screen test at 15 or 30 degrees in 23 nonsurgical blow-out fracture patients without muscle entrapment or strong mechanical ocular restriction and in eight surgical patients with the above. In nonsurgical patients, the eyes moved more than 10 or 20 degrees respectively on a 15- or 30-degree Hess screen test in the early period, whereas in the surgical patients, the eyes did not. No nonsurgical patients had serious ocular motility disturbances; however, natural ocular motility recovery in many patients took more than 4 weeks. When an involved eye without muscle entrapment or strong mechanical restrictions moves more than 10 or 20 degrees on each Hess chart, natural recovery can be expected.