Zusammenfassung
Die Behandlung orbitaler Verletzungen gehört zum Alltag der medizinischen Akutversorgung.
Bei 10 – 25% aller Gesichtsverletzungen ist die Orbita beteiligt. Dieser Beitrag gibt
einen Überblick über die möglichen Pathologien nach Orbitatrauma sowie das primärdiagnostische
Vorgehen und die therapeutischen Optionen.
Abstract
Orbital trauma is a common medical emergency with potentially sight-threatening complications.
Due to the confined orbital conditions, any direct injury or space-consuming lesion
may cause serious tissue damage. Possible complications are orbital fractures, foreign
body injuries, development of orbital compartment syndrome and traumatic optic neuropathy.
Clinical signs include periorbital hematoma or emphysema, subconjunctival hemorrhage,
proptosis, decreased ocular mobility, decreased vision, increased intraocular pressure
and relative afferent pupillary defect. Ophthalmic status and low-dose CT-imaging
provide key information regarding the therapeutic decision. Treatment options include
surgical exploration, reconstruction or decompression or a conservative approach with
anti-inflammatory or anti-glaucomatous medication. Rapid interdisciplinary diagnostics
and therapy is critical for early detection and prevention of irreversible functional
loss respectively.
Considering the frequent association with life-threatening comorbidities diagnosis
may be complicated.
Schlüsselwörter
Trauma der Orbita - orbitales Kompartmentsyndrom - orbitaler Fremdkörper - traumatische
Optikusneuropathie
Key words
orbital trauma - orbital compartment syndrome - intraorbital foreign body - traumatic
optic neuropathy