Incarceration of the inferior rectus muscle within a trap door fracture may rapidly result in ischemic injury of the muscle and subsequent restrictive strabismus. However, diplopia itself does not imply extraocular muscle entrapment as soft tissue swelling, hematoma, or nerve paresis can also lead to restricted ocular movement [9]. The presence of visual loss or visual field defects suggests direct or indirect injury to the globe or optic nerve. Open globe injury may be a result of blunt trauma (globe rupture) or penetrating injury (globe laceration). Penetrating injuries may also be associated with intraorbital foreign body. Imaging may be conducted to assess for the intraorbital foreign body, extent of globe damage, and injury to the surrounding structures [10,11]. CT Head CT of the head may have a complementary role when obtained along with CT orbits in cases in which intracranial abnormality or calvarial fracture is suspected, particularly in children with suspected orbital roof fracture. Outside the setting of concurrent head trauma, there is no relevant literature to support the role for CT head in the initial evaluation of the orbital trauma. CT Orbits CT is considered the most useful imaging modality in evaluating orbital trauma, and it is the most accurate method in detecting fractures [12]. CT may also provide information for the detection of soft tissue injuries (including globe or extraocular muscles), hemorrhage, and presence of an intraocular foreign body. CT was found to be 94.9% sensitive for detection of the intraorbital foreign body, especially metallic or glass foreign bodies [13]. There is no relevant literature to support the role for contrast-enhanced CT orbits in the initial evaluation of the orbital trauma. CTA Head There is no relevant literature to support the use of CT angiography (CTA) head in the initial evaluation of orbital trauma.
Orbital Imaging and Vision Loss Child. Incarceration of the inferior rectus muscle within a trap door fracture may rapidly result in ischemic injury of the muscle and subsequent restrictive strabismus. However, diplopia itself does not imply extraocular muscle entrapment as soft tissue swelling, hematoma, or nerve paresis can also lead to restricted ocular movement [9]. The presence of visual loss or visual field defects suggests direct or indirect injury to the globe or optic nerve. Open globe injury may be a result of blunt trauma (globe rupture) or penetrating injury (globe laceration). Penetrating injuries may also be associated with intraorbital foreign body. Imaging may be conducted to assess for the intraorbital foreign body, extent of globe damage, and injury to the surrounding structures [10,11]. CT Head CT of the head may have a complementary role when obtained along with CT orbits in cases in which intracranial abnormality or calvarial fracture is suspected, particularly in children with suspected orbital roof fracture. Outside the setting of concurrent head trauma, there is no relevant literature to support the role for CT head in the initial evaluation of the orbital trauma. CT Orbits CT is considered the most useful imaging modality in evaluating orbital trauma, and it is the most accurate method in detecting fractures [12]. CT may also provide information for the detection of soft tissue injuries (including globe or extraocular muscles), hemorrhage, and presence of an intraocular foreign body. CT was found to be 94.9% sensitive for detection of the intraorbital foreign body, especially metallic or glass foreign bodies [13]. There is no relevant literature to support the role for contrast-enhanced CT orbits in the initial evaluation of the orbital trauma. CTA Head There is no relevant literature to support the use of CT angiography (CTA) head in the initial evaluation of orbital trauma.