The Role of Saccadic Velocity Testing in the Management of Orbital Fractures

Vicki Webster, Dip AppSc(Cumb), DOBA

The aim of this study was to recorded and compare saccadic ocular movements in patients who sustained orbital trauma and / or orbital fractures. Seventeen patients were used. Ocular saccadic velocities were measured vertically (and horizontally) using a Tracoustic Saccadic Velocity Recorder. Patients with only orbital oedema and haemorrhage, who presented with a clinical picture of blow out fracture, gave normal saccadic velocity readings and ocular deviation disappeared soon after trauma. In patients with orbital fractures, saccadic velocity measurements proved to helpful In identifying those patients who would have a persistent deviation after surgical repair of the fracture.
It is shown that saccadic velocity measurements can differentiate limitation of ocular rotation secondary to orbital oedema and haemorrhage and tissue incarceration, from those due to inferior rectus muscle paresis, even in mild cases. This information is of value to the surgeon in deciding management of the case.