FREQUENCY OF DIFFERENT OPHTHALMIC INJURIES IN PATIENTS WITH ZYGOMATICOMAXILLARY COMPLEX FRACTURE

Background: Zygomaticomaxillary complex (ZMC) fractures are common midfacial injuries due to the prominent position of the zygoma and its close anatomical relationship with the orbit. These fractures frequently result in ophthalmic complications ranging from mild soft tissue injuries to severe visual impairment. Early identification of such injuries is essential to prevent long-term morbidity. Objective: To determine the frequency and pattern of different ophthalmic injuries in patients presenting with zygomaticomaxillary complex fractures. Methods: This cross-sectional descriptive study was conducted in the Departments of Oral and Maxillofacial Surgery at Nishter Institute of Dentistry, Multan from February to July 2025. A total of 196 patients aged 18–65 years with radiologically confirmed ZMC fractures were included using non-probability consecutive sampling. Patients with previous orbital trauma or pre-existing ophthalmic conditions were excluded. Data were collected through clinical examination, CT imaging, and comprehensive ophthalmic assessment including visual acuity, pupillary reflexes, extraocular movements, slit-lamp, and fundoscopic examination. Data were analyzed using SPSS version 25, and Chi-square test was applied to assess associations, with p ≤ 0.05 considered statistically significant. Results: Out of 196 patients, 70% were males and 50% belonged to the 18–30 years age group. Road traffic accidents were the most common cause (56.1%). The most frequent ophthalmic injuries were periorbital edema (85%) and subconjunctival hemorrhage (78%), followed by infraorbital nerve paresthesia (40%), diplopia (32%), restricted ocular movements (25%), enophthalmos (18%), visual impairment (12%), and globe injury (3%). A statistically significant association was found between fracture severity and the occurrence of diplopia, enophthalmos, and restricted ocular movements (p ≤ 0.05). Conclusion: Ophthalmic injuries are common in ZMC fractures, with most being mild; however, significant functional complications may occur in displaced fractures. Routine ophthalmic evaluation and a multidisciplinary management approach are essential to ensure early detection and prevent long-term visual morbidity.