Impaired mobility of the eyeball in patients with traumatic strabismus

Relevance. Limitation of eyeball mobility is one of the main signs of traumatic strabismus. The following main factors of its occurrence have been identified: trauma to the eye and periorbital region, orbital fracture, concussion and severe cranio-orbital or traumatic brain injury. Oculomotor function may suffer due to paresis/paralysis of the extraocular muscle, its mechanical damage or entrapment in the area of the fracture of the orbital bones (in cases where strabismus has developed as a result of an orbital fracture), or due to the formation of severe tissue fibrosis and restriction. Purpose. To study the dynamics of oculomotor function before and after surgical treatment of traumatic strabismus in patients with dystopia of the eyeball and without it. Material and methods. A retrospective analysis of outpatient records of 269 patients with traumatic strabismus was carried out. Results. Dystopia of the eyeball was detected in 34%. Exophthalmos accounts for approximately a third of all dystopias occurring in traumatic strabismus. An isolated fracture of the orbital wall did not cause exophthalmos. In such cases, other types of dystopias were noted. But in more extensive and severe injuries to the skull, exophthalmos occurred in 10% of cases. Among all cases of exophthalmos, in 40% it developed as a result of injury to the eye or periorbital region, in 60% – with severe cranio-orbital damages (COD) and head injury. It was found that as a result of surgical treatment, the number of patients with normal eyeball mobility increased from 16 to 24%. Lack of eyeball mobility was noted in 7% of patients, while before treatment their number was almost 19%. In the group without dystopia with moderate oculomotor disorders, after treatment, the mobility of the eyeball did not improve in 65% of patients; it improved in 31% of patients; in the group with dystopia, 41% retained the same degree of mobility limitation, and improvement (decrease in the degree of limitation) was detected in 55% of patients. Conclusion.It has been established that dystopia causes more severe oculomotor disorders. However, adequate surgical treatment can improve eye mobility in more than half of the patients. Key words: traumatic strabismus, dystopia, orbital rupture, eyeball mobility, restriction, fibrosis