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  • Title: Quantitative evaluation of ocular motility in blow-out fractures for selection of nonsurgically managed cases.
    Author: Nishida Y, Hayashi O, Miyake T, Kakinoki M, Yoshida K, Iwami T, Mekada A, Yakushigawa H, Suzuki M.
    Journal: Am J Ophthalmol; 2004 Apr; 137(4):777-9. PubMed ID: 15059733.
    Abstract:
    PURPOSE: To clarify in which cases of blow-out fractures ocular motility will naturally recover. DESIGN: A retrospective review of observational cases. METHODS: Involved ocular motility ranges were measured by the Hess screen test at 15 or 30 degrees in 23 nonsurgical blow-out fracture patients without muscle entrapment or strong mechanical ocular restriction and in eight surgical patients with the above. RESULTS: In nonsurgical patients, the eyes moved more than 10 or 20 degrees respectively on a 15- or 30-degree Hess screen test in the early period, whereas in the surgical patients, the eyes did not. No nonsurgical patients had serious ocular motility disturbances; however, natural ocular motility recovery in many patients took more than 4 weeks. CONCLUSIONS: When an involved eye without muscle entrapment or strong mechanical restrictions moves more than 10 or 20 degrees on each Hess chart, natural recovery can be expected.
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