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Fraturas orbitais

Last reviewed: 12 Aug 2025
Last updated: 01 Apr 2025

Summary

Definition

History and exam

Key diagnostic factors

  • diplopia ao olhar para cima
  • alteração da posição do globo
  • distância intercantal aumentada
  • sintomas oculovagais (bradicardia, hipotensão, náuseas/vômitos)
Full details

Other diagnostic factors

  • distúrbio visual
  • equimose periorbital
  • edema periorbital
  • perda da sensibilidade do nervo
  • hemorragia subconjuntival
  • defeito de alinhamento da borda infraorbital
  • perda da visão das cores
  • reflexo pupilar à luz alterado
  • acuidade visual reduzida
Full details

Risk factors

  • trauma direto
  • adultos jovens e crianças
  • idosos em risco de quedas
  • sexo masculino
Full details

Diagnostic investigations

1st investigations to order

  • radiografia da face
  • tomografia computadorizada (TC) da órbita
Full details

Investigations to consider

  • ressonância nuclear magnética (RNM) da órbita
  • teste de ducção forçada
  • teste ortóptico
Full details

Emerging tests

  • exame ultrassonográfico orbital

Treatment algorithm

ACUTE

morbidade ocular urgente

sem morbidade ocular urgente

Contributors

Authors

Alistair R.M. Cobb, MBBS, BDS, FRCS (OMFS), FDSRCS (Eng), MFSEM (UK)

Consultant Oral and Maxillofacial Surgeon

South West Cleft Service

United Hospitals Bristol NHS Trust

Bristol

UK

Disclosures

ARMC is an author of a number of references cited in this topic.

Acknowledgements

Mr Alistair Cobb would like to gratefully acknowledge Mr Timothy Lloyd, a previous contributor to this topic.

Disclosures

TL declares that he has no competing interests.

Peer reviewers

Andrew Parfitt, MBBS, FFAEM

Clinical Director

Acute Medicine

Associate Medical Director

Consultant Emergency Medicine

Guy's and St Thomas' NHS Foundation Trust

Clinical Lead and Consultant

Accident Emergency Medicine

St Thomas' Hospital

London

UK

Disclosures

AP declares that he has no competing interests.

Mark I. Neuman, MD

Assistant Professor of Pediatrics

Children's Hospital Boston

Harvard Medical School

Boston

MA

Disclosures

MIN declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

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Key articles

Manolidis S, Weeks BH, Kirby M, et al. Classification and surgical management of orbital fractures: experience with 111 orbital reconstructions. J Craniofac Surg. 2002 Nov;13(6):726-37. Abstract

Cobb A, Murthy R, Manisali M, et al. Oculovagal reflex in paediatric orbital floor fractures mimicking head injury. Emerg Med J. 2009 May;26(5):351-3.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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