Complications

Complication
Timeframe
Likelihood
short term
low

Postsurgical emphysema around the eye is common following nose blowing. Patients are advised to avoid blowing their nose for 2 weeks after surgery.

short term
low

An uncommon, vision-threatening complication of orbit and eyelid surgery. Retrobulbar hemorrhage causes increased intraorbital pressure and pressure on the accompanying vessels of the optic nerve, decreasing blood flow and thus leading to an ischemic optic neuritis.

Management is pharmacologic plus surgical decompression. Treatment includes intravenous corticosteroids such as dexamethasone or hydrocortisone, mannitol, and acetazolamide to decrease aqueous humor volume. Patient should be prepared for immediate surgical decompression. If there is any delay, the patient may benefit from lateral canthotomy and cantholysis in the emergency department under local anesthetic.[25][30]

short term
low

May result from vagal stimulation (bradycardia progressing to worse bradycardia, asystole, cardiopulmonary arrest, and death).

short term
low

Orbital cellulitis is a rare but serious complication of orbital fractures. Routine antibiotic prophylaxis has not been proven to prevent orbital cellulitis or abscess formation. Surgery may be required in some patients to drain orbital abscess, or to drain the paranasal sinuses in nonresolving cellulitis.[31]

variable
medium

In the case of operated or conservative management, persistent or even permanent diplopia remains a potential adverse outcome. Initial surgical intervention aims to correct this.

variable
medium

The orbital medial wall is particularly difficult to reconstruct accurately and may require secondary surgery, sometimes with custom-made prosthesis for the bony defect.

variable
medium

Due to entrapped soft tissues leading to fibrosis, there may be ocular muscle damage and cranial nerve injury.

variable
low

Due to deranged globe position.

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