Observation may be indicated in non- or slightly dislocated medial orbital wall fractures where increase in orbital volume is minimal and there is no disturbance of eye motility. Observation may also be necessary in cases where patient condition does not allow for surgical intervention.
The decision to observe or to perform surgery is based on thorough clinical and radiographic (CT) evaluation because correction of a potential secondary deformity is challenging.
Due to periorbital edema following trauma, the majority of patients may initially present with proptosis. It may only become apparent that the patient is developing enophthalmos or dystopia when the edema has resolved after approximately two weeks. The patient needs to be examined and reassessed regularly and often. Additionally, ophthalmological examination is recommended. If any disturbance of eye mobility or globe position develops, CT reexamination (and in special circumstances an MRI examination) may be indicated and operative treatment may become necessary.
Information on retrobulbar hemmorage can be found here.
For aftercare and rehabilitation following observation please refer to your local protocol.