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A Journal on Ophthalmology
Minerva Oftalmologica 2002 September-December;44(3-4):127-38
Multidisciplinary surgical approach to sports-related ocular and orbital trauma
Nuzzi R., Minazzi G. L., Donati S., Arturi L.
A variety of traumatic injuries to the orbital area, the adnexa and the eyeball may occur in sporting activities. When these injuries occur together, they require a multidisciplinary clinical evaluation and surgical treatment. Orbital trauma may be caused by bicycle falls, by thrusts with the elbow, by butts, by club blows, by tennis-racket blows and by horse kicks. Orbital floor fractures are the most common among orbital fractures. It is up first of all to ophthalmolgist and secondly to maxillo-facial surgeon to repair the fractures of the floor, whereas for the other orbital fractures multidisciplinary competence-limits are not always clear. In case of extension of upper orbital fractures to optical canal, the ophthalmologist plays a prominent part in medical and surgical decision making. Variously severe traumatic injuries to the adnexa may occurr by playing contact-sports, water-polo and ski. These injuries must be early treated by the ophthalmologist and the plastic reconstructive surgeon together. It is up to the ophthalmologist surgeon only to manage blunt or penetrating ocular trauma (that may occur in tennis, squash, baseball, basket, football, boxing). Whenever a trauma occurs, priority must be given to the safeguard of the patient's vital functions. The treatments of the orbital and ocular injuries must be performed every time according to their urgency and seriousness. To improve the efficiency of the management of the orbital and ocular trauma it would be useful to establish multidisciplinary regional centres. They could be linked by data transmission with suburban hospitals according to the ''Patatrac'' (Piemonte Valle d'Aosta Tomografia Assiale Trauma Cranico) project.