Patients with traumatic orbital injury may have injuries that are isolated to the orbit or have intracranial manifestations, depending on the mechanism and severity of injury. In the United States, orbital trauma accounts for approximately 3% of visits to the emergency department [8]. Orbital injury should be suspected if periorbital soft-tissue swelling, hyphema, vision loss, or extraocular restriction is present. The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through society representation on expert panels. Participation by representatives from collaborating societies on the expert panel does not necessarily imply individual or society endorsement of the final document. *The views expressed in this manuscript are those of the author and do not reflect the official policy of the Department of Army/Navy/Air Force, Department of Defense, or United States Government. Reprint requests to: publications@acr.org Orbits, Vision and Visual Loss Radiography Orbital or skull radiographs are insufficient to detect pathology in patients presenting with trauma and have primarily been supplanted by CT. Variant 2: Nontraumatic orbital asymmetry, exophthalmos, or enophthalmos. Initial imaging. Orbital asymmetry is a broad term that refers to the external appearance of the orbit. This asymmetry may be related to globe position, with one eye perceived or measured as more proptotic compared to the other, or one eye perceived as sunken or retracted compared to the other. Normal range measurements vary and are dependent on the race of the individual [18,19]. Bilateral exophthalmos may indicate an underlying systemic or diffuse condition, such as thyroid eye disease.
Orbits Vision and Visual Loss. Patients with traumatic orbital injury may have injuries that are isolated to the orbit or have intracranial manifestations, depending on the mechanism and severity of injury. In the United States, orbital trauma accounts for approximately 3% of visits to the emergency department [8]. Orbital injury should be suspected if periorbital soft-tissue swelling, hyphema, vision loss, or extraocular restriction is present. The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through society representation on expert panels. Participation by representatives from collaborating societies on the expert panel does not necessarily imply individual or society endorsement of the final document. *The views expressed in this manuscript are those of the author and do not reflect the official policy of the Department of Army/Navy/Air Force, Department of Defense, or United States Government. Reprint requests to: publications@acr.org Orbits, Vision and Visual Loss Radiography Orbital or skull radiographs are insufficient to detect pathology in patients presenting with trauma and have primarily been supplanted by CT. Variant 2: Nontraumatic orbital asymmetry, exophthalmos, or enophthalmos. Initial imaging. Orbital asymmetry is a broad term that refers to the external appearance of the orbit. This asymmetry may be related to globe position, with one eye perceived or measured as more proptotic compared to the other, or one eye perceived as sunken or retracted compared to the other. Normal range measurements vary and are dependent on the race of the individual [18,19]. Bilateral exophthalmos may indicate an underlying systemic or diffuse condition, such as thyroid eye disease.