{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T23:56:28Z","timestamp":1791244588599,"version":"4.1.0"},"reference-count":48,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,5,17]],"date-time":"2025-05-17T00:00:00Z","timestamp":1747440000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,5,17]],"date-time":"2025-05-17T00:00:00Z","timestamp":1747440000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Bundeswehrkrankenhaus Ulm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int Ophthalmol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The necessity of a specialized ophthalmological assessment following fractures of the zygomaticoorbital (ZMO) complex in an emergency setting is still debated in resource-limited health systems. The primary aim of this study was to determine the incidence and types of ocular and periocular injuries (OPIs) associated with different fracture patterns of the ZMO complex. The secondary aim was to investigate the association between patient- and trauma-specific variables with the different types of OPI and identify high-risk patients for severe OPI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study was conducted on patients with ZMO complex fractures over a seven-year period. All patients underwent a specialized ophthalmic assessment in the ophthalmology clinic within 24\u00a0h of initial admission. Visual acuity, extraocular eye movements, and pupillary reaction were examined to determine the type of OPI that occurred. Demographic and medical history data, clinical and radiological findings and specific OPIs were recorded. Demographics, fracture patterns and ophthalmological findings were presented using descriptive statistical analysis. A multivariable analysis was performed to identify associations between predictor factors (etiology of injury, fracture pattern, pre-traumatic ophthalmological conditions, antithrombotic therapy) and OPI severity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>489 patients with a mean age of 50.88\u00a0years and a total of 540 examined eyes met the inclusion criteria. Ground-level fall was the most common etiology of injury. Periocular hematomas (28.99%), subconjunctival hemorrhage (18.65%) and periorbital swelling (15.13%) were the most common ophthalmologic findings. Eye motility disorders (p\u2009=\u20090.0003) and diplopia (p\u2009=\u20090.0019) were significantly more common in isolated orbital wall fractures than in other midface fracture patterns. Chemosis was significantly more common in fractures of the zygomaticoorbital complex (p\u2009=\u20090.0199), while lid tears (p\u2009=\u20090.0470) and open globe injuries (p\u2009=\u20090.0002) were more common in Le Fort fractures. Optic disc hemorrhage occurred significantly more frequently in patients under single antithrombotic therapy (p\u2009=\u20090.0171). Blow from blunt objects and Le Fort fractures were associated with higher rates of severe OPI, while pre-traumatic ophthalmologic conditions and antithrombotic therapy were not.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Within the limitations of the study, patients who experienced blows from blunt objects and those with Le Fort fractures are at a higher risk for severe OPIs. Early specialized ophthalmological consultation is recommended for patients with zygomatic fractures and orbital involvement, especially for those with visual alterations such as motility disorders and diplopia as well as those taking antithrombotic medication.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10792-025-03566-7","type":"journal-article","created":{"date-parts":[[2025,5,17]],"date-time":"2025-05-17T03:48:13Z","timestamp":1747453693000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Retrospective evaluation of ocular injuries in fractures of the zygomaticoorbital complex in a level I trauma center: is primary specialized ophthalmologic examination always necessary?"],"prefix":"10.1007","volume":"45","author":[{"given":"Vanessa","family":"Kramer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Efstathios","family":"Vounotrypidis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Steinkohl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christel","family":"Wei\u00df","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Schramm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Wilde","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel","family":"Ebeling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Sakkas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,5,17]]},"reference":[{"issue":"3","key":"3566_CR1","doi-asserted-by":"crossref","first-page":"845","DOI":"10.3390\/jcm12030845","volume":"12","author":"U Committeri","year":"2023","unstructured":"Committeri U, Arena A, Carraturo E, Austoni M, Germano C, Salzano G (2023) Incidence of orbital side effects in zygomaticomaxillary complex and isolated orbital walls fractures: a retrospective study in south Italy and a brief review of the literature. JCM 12(3):845","journal-title":"JCM"},{"issue":"3","key":"3566_CR2","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1016\/j.bjoms.2018.02.009","volume":"56","author":"NR Johnson","year":"2018","unstructured":"Johnson NR, Singh NR, Oztel M, Vangaveti VN, Rahmel BB, Ramalingam L (2018) Ophthalmological injuries associated with fractures of the orbitozygomaticomaxillary complex. Br J Oral Maxillofac Surg 56(3):221\u2013226","journal-title":"Br J Oral Maxillofac Surg"},{"issue":"2","key":"3566_CR3","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1007\/s12663-020-01441-9","volume":"21","author":"R Malick","year":"2022","unstructured":"Malick R, Sham ME, Menon S, Kumar V, Archana S, Mathews S (2022) Ophthalmic complications associated with zygomatic complex fractures: a randomised descriptive clinical study. J Maxillofac Oral Surg 21(2):386\u2013395","journal-title":"J Maxillofac Oral Surg"},{"issue":"3","key":"3566_CR4","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1007\/s12663-015-0844-8","volume":"15","author":"SG Patil","year":"2016","unstructured":"Patil SG, Kotwal IA, Joshi U, Allurkar S, Thakur N, Aftab A (2016) Ophthalmological evaluation by a maxillofacial surgeon and an ophthalmologist in assessing the damage to the orbital contents in midfacial fractures: a prospective study. J Maxillofac Oral Surg 15(3):328\u2013335","journal-title":"J Maxillofac Oral Surg"},{"issue":"12","key":"3566_CR5","doi-asserted-by":"crossref","first-page":"1935","DOI":"10.1016\/j.jcms.2019.10.001","volume":"47","author":"Z Catherine","year":"2019","unstructured":"Catherine Z, Courvoisier DS, Scolozzi P (2019) Is the pure and impure distinction of orbital fractures clinically relevant with respect to ocular and periocular injuries? A retrospective study of 473 patients. J Craniomaxillofac Surg 47(12):1935\u20131942","journal-title":"J Craniomaxillofac Surg"},{"issue":"7","key":"3566_CR6","doi-asserted-by":"crossref","first-page":"e661","DOI":"10.1097\/SCS.0000000000003823","volume":"28","author":"P Scolozzi","year":"2017","unstructured":"Scolozzi P, Jacquier P, Courvoisier DS (2017) Can clinical findings predict orbital fractures and treatment decisions in patients with orbital trauma? Derivation of a simple clinical model. J Craniofac Surg 28(7):e661\u2013e667","journal-title":"J Craniofac Surg"},{"issue":"3","key":"3566_CR7","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1007\/s10006-019-00775-0","volume":"23","author":"R Marano","year":"2019","unstructured":"Marano R, Lino PRS, Zanetti F, Tincani AJ, Oliveira L (2019) Is specialized ophthalmologic evaluation necessary after orbital fractures? A prospective 64-case study. Oral Maxillofac Surg 23(3):325\u2013329","journal-title":"Oral Maxillofac Surg"},{"key":"3566_CR8","doi-asserted-by":"crossref","first-page":"4153","DOI":"10.2147\/OPTH.S391175","volume":"16","author":"E Zhong","year":"2022","unstructured":"Zhong E, Chou TY, Chaleff AJ, Scofield-Kaplan SM, Perzia BM, Naqvi J (2022) Orbital fractures and risk factors for ocular injury. Clin Ophthalmol 16:4153\u20134161","journal-title":"Clin Ophthalmol"},{"key":"3566_CR9","doi-asserted-by":"publisher","DOI":"10.1016\/j.joms.2025.03.012","author":"DL Oliver","year":"2025","unstructured":"Oliver DL, Gernandt S, Aymon R, Scolozzi P (2025) Are orbital fracture location, visual disturbances, and head injury associated with severe ocular and periocular injuries? A retrospective cohort study. J Oral Maxillofac Surg. https:\/\/doi.org\/10.1016\/j.joms.2025.03.012","journal-title":"J Oral Maxillofac Surg"},{"issue":"5","key":"3566_CR10","doi-asserted-by":"crossref","first-page":"1308","DOI":"10.1097\/TA.0b013e31825c78d9","volume":"73","author":"D Scruggs","year":"2012","unstructured":"Scruggs D, Scruggs R, Stukenborg G, Netland PA, Calland JF (2012) Ocular injuries in trauma patients: an analysis of 28,340 trauma admissions in the 2003\u20132007 national trauma data bank national sample program. J Trauma Acute Care Surg 73(5):1308\u20131312","journal-title":"J Trauma Acute Care Surg"},{"key":"3566_CR11","doi-asserted-by":"publisher","DOI":"10.5935\/0004-2749.2021-0456","author":"Y Steinberg","year":"2022","unstructured":"Steinberg Y, Wieder MS, Denisova K, He C, Parsikia A, Mbekeani JN (2022) Evaluation of commotio retinae in orbital fractures. ABO. https:\/\/doi.org\/10.5935\/0004-2749.2021-0456","journal-title":"ABO"},{"issue":"5","key":"3566_CR12","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1016\/j.jcjo.2017.01.013","volume":"52","author":"M Ross","year":"2017","unstructured":"Ross M, El-Haddad C, Desch\u00eanes J (2017) Ocular injury in orbital fractures at a level I trauma center. Can J Ophthalmol 52(5):499\u2013502","journal-title":"Can J Ophthalmol"},{"issue":"1","key":"3566_CR13","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1001\/jamaophthalmol.2020.5108","volume":"139","author":"EJ Rossin","year":"2021","unstructured":"Rossin EJ, Szypko C, Giese I, Hall N, Gardiner MF, Lorch A (2021) Factors associated with increased risk of serious ocular injury in the setting of orbital fracture. JAMA Ophthalmol 139(1):77","journal-title":"JAMA Ophthalmol"},{"issue":"6","key":"3566_CR14","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1097\/IOP.0000000000001422","volume":"35","author":"K Richani","year":"2019","unstructured":"Richani K, Do TH, Merritt HA, Pfeiffer ML, Chuang AZ, Phillips ME (2019) Screening criteria for detecting severe ocular injuries in the setting of orbital fractures. Ophthalmic Plast Reconstr Surg 35(6):609\u2013614","journal-title":"Ophthalmic Plast Reconstr Surg"},{"issue":"4","key":"3566_CR15","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1097\/IOP.0b013e3181aa9a73","volume":"25","author":"PA Mellema","year":"2009","unstructured":"Mellema PA, Dewan MA, Lee MS, Smith SD, Harrison AR (2009) Incidence of ocular injury in visually asymptomatic orbital fractures. Ophthalmic Plastic Reconstr Surg 25(4):306\u2013308","journal-title":"Ophthalmic Plastic Reconstr Surg"},{"key":"3566_CR16","doi-asserted-by":"publisher","DOI":"10.2147\/OPTH.S80463","author":"J Boyette","year":"2015","unstructured":"Boyette J, Pemberton J, Bonilla-Velez J (2015) Management of orbital fractures: challenges and solutions. Clin Ophthalmol. https:\/\/doi.org\/10.2147\/OPTH.S80463","journal-title":"Clin Ophthalmol"},{"issue":"7","key":"3566_CR17","doi-asserted-by":"crossref","first-page":"1507","DOI":"10.1016\/j.joms.2021.02.026","volume":"79","author":"A Rockafellow","year":"2021","unstructured":"Rockafellow A, Busby E, WuDunn D, Grover S, Salman SO (2021) Evidence-based protocol for ophthalmology consult for orbital fractures. J Oral Maxillofac Surg 79(7):1507\u20131513","journal-title":"J Oral Maxillofac Surg"},{"issue":"12","key":"3566_CR18","doi-asserted-by":"crossref","first-page":"1500","DOI":"10.1016\/j.ijsu.2014.07.014","volume":"12","author":"JP Vandenbroucke","year":"2014","unstructured":"Vandenbroucke JP, von Elm E, Altman DG, G\u00f8tzsche PC, Mulrow CD, Pocock SJ (2014) Strengthening the reporting of observational studies in epidemiology (STROBE): explanation and elaboration. Int J Surg 12(12):1500\u20131524","journal-title":"Int J Surg"},{"issue":"11","key":"3566_CR19","doi-asserted-by":"crossref","first-page":"2370","DOI":"10.1016\/j.joms.2018.04.024","volume":"76","author":"J Chow","year":"2018","unstructured":"Chow J, Parthasarathi K, Mehanna P, Whist E (2018) Primary assessment of the patient with orbital fractures should include pupillary response and visual acuity changes to detect occult major ocular injuries. J Oral Maxillofac Surg 76(11):2370\u20132375","journal-title":"J Oral Maxillofac Surg"},{"issue":"3","key":"3566_CR20","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1177\/1943387520922056","volume":"13","author":"M Blumer","year":"2020","unstructured":"Blumer M, Rostetter C, Johner JP, Ebner JJ, Wiedemeier D, R\u00fccker M (2020) Associated ophthalmic injuries in patients with fractures of the midface. Craniomaxillofac Trauma Reconstr 13(3):168\u2013173","journal-title":"Craniomaxillofac Trauma Reconstr"},{"issue":"3","key":"3566_CR21","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/j.jcms.2024.01.001","volume":"52","author":"N Shikha","year":"2024","unstructured":"Shikha N, Reghunadhan P, Upasi AP, Rai KK, Kocher V (2024) Simplified practice for ophthalmologist consultation in malar fractures: a retrospective study. J Craniomaxillofac Surg 52(3):297\u2013301","journal-title":"J Craniomaxillofac Surg"},{"key":"3566_CR22","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25805","author":"BT Andrews","year":"2015","unstructured":"Andrews BT, Jackson AS, Nazir N, Hromas A, Sokol JA, Thurston TE (2015) Orbit fractures: identifying patient factors indicating high risk for ocular and periocular injury. Laryngoscope. https:\/\/doi.org\/10.1002\/lary.25805","journal-title":"Laryngoscope"},{"issue":"7","key":"3566_CR23","doi-asserted-by":"crossref","first-page":"1624","DOI":"10.1002\/lary.30477","volume":"133","author":"JF Eng","year":"2023","unstructured":"Eng JF, Younes S, Crovetti BR, Williams KJ, Haskins AD, Hernandez DJ (2023) Characteristics of orbital injuries associated with maxillofacial trauma. Laryngoscope 133(7):1624\u20131629","journal-title":"Laryngoscope"},{"key":"3566_CR24","doi-asserted-by":"crossref","first-page":"2837","DOI":"10.2147\/OPTH.S274567","volume":"14","author":"SB Terrill","year":"2020","unstructured":"Terrill SB, You H, Eiseman H, Rauser ME (2020) Review of ocular injuries in patients with orbital wall fractures: a 5-year retrospective analysis. Clin Ophthalmol 14:2837\u20132842","journal-title":"Clin Ophthalmol"},{"issue":"1","key":"3566_CR25","doi-asserted-by":"crossref","first-page":"33","DOI":"10.4103\/njs.NJS_21_20","volume":"27","author":"B Fomete","year":"2021","unstructured":"Fomete B, Adebayo ET, Agbara R, Osunde DO, Abah ER (2021) Pattern of ocular involvement in midface injuries seen at a tertiary care hospital in northern Nigeria. Niger J Surg 27(1):33\u201337","journal-title":"Niger J Surg"},{"issue":"9","key":"3566_CR26","first-page":"1","volume":"17","author":"HM Hashemi","year":"2020","unstructured":"Hashemi HM, Avval SK (2020) Prevalence of ocular complications in patients with zygomatic bone fractures in an Iranian population. Front Dent 17(9):1\u20134","journal-title":"Front Dent"},{"issue":"2","key":"3566_CR27","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1007\/s12663-016-0907-5","volume":"16","author":"AH Malik","year":"2017","unstructured":"Malik AH, Shah AA, Ahmad I, Shah BA (2017) Ocular injuries in patients of zygomatico-complex (ZMC) fractures. J Maxillofac Oral Surg 16(2):243\u2013247","journal-title":"J Maxillofac Oral Surg"},{"issue":"3","key":"3566_CR28","first-page":"41","volume":"5","author":"MS Brown","year":"1999","unstructured":"Brown MS, Ky W, Lisman RD (1999) Concomitant ocular injuries with orbital fractures. J Craniomaxillofac Trauma 5(3):41\u201346","journal-title":"J Craniomaxillofac Trauma"},{"issue":"2","key":"3566_CR29","doi-asserted-by":"crossref","first-page":"152","DOI":"10.4103\/0975-5950.111370","volume":"3","author":"G Mittal","year":"2012","unstructured":"Mittal G, Singh N, Suvarana S, Mittal S (2012) A prospective study on ophthalmic injuries related to maxillofacial trauma in Indian population. Natl J Maxillofac Surg 3(2):152","journal-title":"Natl J Maxillofac Surg"},{"issue":"4","key":"3566_CR30","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1007\/s12663-015-0778-1","volume":"14","author":"GC Rajkumar","year":"2015","unstructured":"Rajkumar GC, Ashwin DP, Singh R, Prashanth R, Rudresh KB (2015) Ocular injuries associated with midface fractures: a 5 year survey. J Maxillofac Oral Surg 14(4):925\u2013929","journal-title":"J Maxillofac Oral Surg"},{"issue":"2","key":"3566_CR31","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1007\/s12663-012-0452-9","volume":"13","author":"D Septa","year":"2014","unstructured":"Septa D, Newaskar VP, Agrawal D, Tibra S (2014) Etiology, incidence and patterns of mid-face fractures and associated ocular injuries. J Maxillofac Oral Surg 13(2):115\u2013119","journal-title":"J Maxillofac Oral Surg"},{"issue":"6","key":"3566_CR32","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1016\/0266-4356(91)90001-L","volume":"29","author":"IA Al-Qurainy","year":"1991","unstructured":"Al-Qurainy IA, Dutton GN, Titterington DM, Stassen LFA, Moos KF, El-Attar A (1991) Midfacial fractures and the eye: the development of a system for detecting patients at risk of eye injury. Br J Oral Maxillofac Surg 29(6):363\u2013367","journal-title":"Br J Oral Maxillofac Surg"},{"issue":"2","key":"3566_CR33","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1016\/j.otohns.2003.09.018","volume":"130","author":"JL Shere","year":"2004","unstructured":"Shere JL, Boole JR, Holtel MR, Amoroso PJ (2004) An analysis of 3599 midfacial and 1141 orbital blowout fractures among 4426 United States army soldiers, 1980\u201320001. Otolaryngol Head Neck Surg 130(2):164\u2013170","journal-title":"Otolaryngol Head Neck Surg"},{"issue":"5","key":"3566_CR34","doi-asserted-by":"crossref","first-page":"888","DOI":"10.1016\/j.joms.2008.01.005","volume":"66","author":"C Barry","year":"2008","unstructured":"Barry C, Coyle M, Idrees Z, Dwyer MH, Kearns G (2008) Ocular findings in patients with orbitozygomatic complex fractures: a retrospective study. J Oral Maxillofac Surg 66(5):888\u2013892","journal-title":"J Oral Maxillofac Surg"},{"issue":"1","key":"3566_CR35","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1007\/s00417-020-04786-6","volume":"259","author":"H Noh","year":"2021","unstructured":"Noh H, Chung JK, Woo KI, Kim YD (2021) Occurrence of ocular injury and orbital fracture in orbital blunt trauma patients at tertiary care center emergency room. Graefes Arch Clin Exp Ophthalmol 259(1):165\u2013171","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"issue":"4","key":"3566_CR36","doi-asserted-by":"crossref","first-page":"1511","DOI":"10.1097\/SCS.0000000000007499","volume":"32","author":"MS Mangan","year":"2021","unstructured":"Mangan MS, Goker AE, YurttaserOcak S, Uyar Y (2021) Comparison of nasoseptal cartilage graft versus titanium mesh in reconstruction of pure orbital blowout fractures. J Craniofac Surg 32(4):1511\u20131514","journal-title":"J Craniofac Surg"},{"issue":"11","key":"3566_CR37","doi-asserted-by":"crossref","first-page":"2541","DOI":"10.1007\/s00417-019-04455-3","volume":"257","author":"J Santamaria","year":"2019","unstructured":"Santamaria J, Mehta A, Reed D, Blegen H, Bishop B, Davies B (2019) Orbital roof fractures as an indicator for concomitant ocular injury. Graefes Arch Clin Exp Ophthalmol 257(11):2541\u20132545","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"issue":"3","key":"3566_CR38","first-page":"10","volume":"4","author":"RW Read","year":"1998","unstructured":"Read RW, Sires BS (1998) Association between orbital fracture location and ocular injury: a retrospective study. J Craniomaxillofac Trauma 4(3):10\u201315","journal-title":"J Craniomaxillofac Trauma"},{"issue":"3","key":"3566_CR39","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1177\/229255030601400303","volume":"14","author":"DY Nagase","year":"2006","unstructured":"Nagase DY, Courtemanche DJ, Peters DA (2006) Facial fractures\u2014association with ocular injuries: a 13-year review of one practice in a tertiary care centre. Can J Plast Surg 14(3):167\u2013171","journal-title":"Can J Plast Surg"},{"key":"3566_CR40","doi-asserted-by":"publisher","DOI":"10.1089\/fpsam.2021.0226","author":"DN Christensen","year":"2022","unstructured":"Christensen DN, Wagner WD, Maar DJ, Shostrom V, Untrauer J, Chundury RV (2022) Orbital wall fractures and ocular injury: impact on management. Facial Plastic Surg Aesthetic Med. https:\/\/doi.org\/10.1089\/fpsam.2021.0226","journal-title":"Facial Plastic Surg Aesthetic Med"},{"issue":"6","key":"3566_CR41","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1016\/S1072-7515(02)01479-5","volume":"195","author":"T Cook","year":"2002","unstructured":"Cook T (2002) Ocular and periocular injuries from orbital fractures. J Am College Surg 195(6):831\u2013834","journal-title":"J Am College Surg"},{"issue":"12","key":"3566_CR42","doi-asserted-by":"crossref","first-page":"915","DOI":"10.1136\/emj.2006.038562","volume":"23","author":"CM Guly","year":"2006","unstructured":"Guly CM, Guly HR, Bouamra O, Gray RH, Lecky FE (2006) Ocular injuries in patients with major trauma. Emerg Med J 23(12):915\u2013917","journal-title":"Emerg Med J"},{"issue":"3","key":"3566_CR43","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1177\/019459988309100313","volume":"91","author":"GR Holt","year":"1983","unstructured":"Holt GR, Holt JE (1983) Incidence of eye injuries in facial fractures: an analysis of 727 cases. Otolaryngol Head Neck Surg 91(3):276\u2013279","journal-title":"Otolaryngol Head Neck Surg"},{"issue":"7","key":"3566_CR44","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1016\/j.ajem.2003.08.009","volume":"21","author":"KO Kreidl","year":"2003","unstructured":"Kreidl KO, Kim DY, Mansour SE (2003) Prevalence of significant intraocular sequelae in blunt orbital trauma. Am J Emerg Med 21(7):525\u2013528","journal-title":"Am J Emerg Med"},{"issue":"8","key":"3566_CR45","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1016\/0007-1226(93)90191-D","volume":"46","author":"LH Lim","year":"1993","unstructured":"Lim LH, Lam LK, Moore MH, Trott JA, David DJ (1993) Associated injuries in facial fractures: review of 839 patients. Br J Plastic Surg 46(8):635\u2013638","journal-title":"Br J Plastic Surg"},{"issue":"9","key":"3566_CR46","first-page":"649","volume":"24","author":"N Riaz","year":"2014","unstructured":"Riaz N, Chatha AA, Warraich RA, Hanif S, Chinar KA, Khan SR (2014) Ophthalmic injuries in orbito-zygomatic fractures. J Coll Phys Surg 24(9):649\u2013652","journal-title":"J Coll Phys Surg"},{"issue":"Suppl 2","key":"3566_CR47","first-page":"S491","volume":"84","author":"P Siritongtaworn","year":"2001","unstructured":"Siritongtaworn P, Tongsawas S, Siltharm S (2001) Diplopia in facial fractures. J Med Assoc 84(Suppl 2):S491\u2013S494","journal-title":"J Med Assoc"},{"issue":"1","key":"3566_CR48","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1007\/s00431-020-03734-0","volume":"180","author":"N Cohen","year":"2021","unstructured":"Cohen N, Cohen E, Anafy A, Margaliot A, Kaganov K, Gomel N (2021) Predictors of traumatic eye injuries at high-risk for ophthalmic complications in children. Eur J Pediatr 180(1):177\u2013185","journal-title":"Eur J Pediatr"}],"container-title":["International Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10792-025-03566-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10792-025-03566-7","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10792-025-03566-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T18:06:30Z","timestamp":1766167590000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10792-025-03566-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,17]]},"references-count":48,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["3566"],"URL":"https:\/\/doi.org\/10.1007\/s10792-025-03566-7","relation":{},"ISSN":["1573-2630"],"issn-type":[{"value":"1573-2630","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,17]]},"assertion":[{"value":"7 November 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 April 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 May 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that they have no competing or financial interests, either directly or indirectly, in the products listed in the study. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Ethical approval for this study was obtained from the ethics committee of the University of Ulm (approval reference: 102\/23, approval date: 05.04.2023). This research was conducted in full accordance with the ethical standards of the institutional research committee as well as with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this non-interventional observational retrospective study, all data were also anonymized and de-identified prior to analysis. Informed written consent of the patient was waived by the ethics committee of the University of Ulm. Full compliance with data protection and safeguarding of data was ensured and no information which could identify the patients was collected. Reporting was based on the recommendations of the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) initiative [\n                      \n                      ].","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}],"article-number":"199"}}