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1. Symptoms (Subjective)...........................................................53
2. Signs (Objective).......................................................................53
C. Classification of Medial Canthal Tendon Injuries................... 57
D. Lacrimal System Injuries............................................................... 57
1. Primary Jones Dye Test............................................................58
2. Secondary Jones Dye Test......................................................58
E. Isolated Orbital Fractures..............................................................59
F. Diagnostic Evaluations. .................................................................59
1. Full-Body Trauma Assessment .............................................59
2. Head and Neck Examination .................................................59
3. Ophthalmological Evaluation ................................................59
4. Inspection of the Nasal Interior............................................ 60
5. Interpupillary and Intercanthal Distance
Measurements ......................................................................... 60
6. Imaging Studies ....................................................................... 60
7. Forced Duction Testing .......................................................... 60
8. Plain Radiographs of the Face ................................................61
9. Digital Photographs ..................................................................61
G. Surgical Management....................................................................62
1. Indications for Surgery.............................................................62
2. Timing of Surgical Procedures...............................................62
3. Surgical Exposure Options......................................................62
4. Reconstructive Options...........................................................66
H. Prevention and Management of Complications......................69
1. Indications for Antibiotics.......................................................69
2. CSF Leaks....................................................................................69
3. Corneal Injuries..........................................................................69
4. Lower Lid Abnormalities.........................................................70
5. Persistent Telecanthus.............................................................70
6. Failure to Correct Medial Orbital Tissue Entrapment......70
7. Persistent Diplopia.....................................................................71
8. Anosmia.......................................................................................71
9. Frontoethmoid Sinusitis............................................................71
III. Summary and Conclusion
..................................................................72
A. Frontal Sinus and Anterior Skull Base Trauma.........................72
B. NOE Fractures..................................................................................72
IV. References
..............................................................................................73
V. Recommended Reading
......................................................................73