Traumatic optic neuropathy (TON) is a rare condition with serious consequences. One common TON cause is orbital wall fracture, which can occur at any site. This study aimed to report the incidence of TON in orbital wall fractures. A systematic search of MEDLINE, Scopus, and the directory of open-access journals was conducted. The following terms were used: (TON OR blindness) AND (craniofacial trauma OR facial fractures OR fracture pattern OR orbital wall fracture OR Visual field orbital wall fractures) AND (Visual acuity OR Visual evoked potential) AND (Mega-dose steroid therapy OR corticosteroids). This review encompassed both randomized controlled trials and observational investigations, comprising both prospective and retrospective studies. Four studies met the inclusion criteria with 2,720 patients included in this study. Most of the patients were males (80%). The study included 3,791 orbital wall fracture subtypes in the patients, with 1,522 having multiple fractures. The highest incidence of fracture was floor fracture, with an event rate (ER) of 42.2%, followed by lateral fracture (ER = 37.9%), roof fracture (ER = 36.2%), and medial fracture with ER (29%). Motor vehicle accidents were the most common injury mechanism reported in 46 patients, compared with traumatic injuries reported in 23 patients. Patients with TON most commonly experienced lateral and superior orbital wall fractures, with periorbital hematoma and subconjunctival hemorrhage being the most common complications. Hence, ophthalmologists treating patients with TON should prepare radiological assessments and consider the surrounding structures to prevent damage to other structures.
Key words: Traumatic optic neuropathy, incidence, orbital walls fractures, ocular injuries, systematic review
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