Primary Assessment of the Patient With Orbital Fractures Should Include Pupillary Response and Visual Acuity Changes to Detect Occult Major Ocular Injuries.

Purpose: Sight-threatening injuries associated with orbital fractures are of major concern to maxillofacial surgeons whom are often the first asked to assess these patients. Eliciting signs and symptoms that are predictive of these injuries would allow expedited ophthalmic consultation and appropriate management. We hypothesized that abnormal pupillary response is predictive of major ocular injuries.

Medical image. Calcified facial haematoma.

Doctors have been promoting alcohol as a health tonic for a very long time. The last 30 years has seen the accumulation of a considerable medical literature investigating the potential role of alcohol use as a protection against coronary heart disease. When viewed through the lens of two major early reviews in the mid-1980s, Sir Richard Doll's contributions of the mid-1990s, two large meta-analyses of 10 years ago and two most recent overviews, the health-giving properties of alcohol use become increasingly debatable.

White-eyed blowout fracture: another look.

Orbital floor fractures have the potential to cause significant morbidity both in the short and long terms and commonly present to the ED for initial assessment. Although treatment of the majority of these injuries involves clinic review and possible later surgery, there is a specific subset that present to emergency clinically suggestive of a head injury. This subset, 'white-eyed blowout', usually occurring under 18 years of age, with a history of trauma and little sign of soft tissue injury, describes a trap door orbital floor fracture with herniation and acute entrapment of orbital muscle and is regarded as a maxillofacial emergency.