The eye examination in facial trauma for the plastic surgeon

Fifteen to 20 percent of patients with major facial trauma suffer vision-threatening injuries. Not only does the early identification and management of such ophthalmic insults frequently carry a better visual prognosis, but manipulations during facial fracture repair may exacerbate unrecognized eye trauma. In addition, ophthalmic problems not documented before facial reconstruction may be interpreted as direct complications of surgery. Thus, all physicians who treat patients with trauma above the mandible should appreciate the fundamentals of ophthalmic evaluation and emergency management. This article strives to provide a simplified, practical guide, but it should not be viewed as a substitute for consultation by a qualified eye care provider when an ocular injury is strongly suspected.