Causes and Characteristics of Peri-Orbital Contusions and Their Relationship with Intracranial Injuries in Inward Patients in Two Tertiary Care Hospitals in Sri Lanka

Introduction: The peri-orbital contusion (PC) is a common injury in day to day surgical casualties. It is a common injury observed in patients who are in an unconscious state following head injuries. The aim of the study is to describe characteristics of PC and understand its relationship with associated injuries, especially with facial injuries and intracranial injuries. Methods: This retrospective study reviewed the medico-legal examination forms (MLEF) of 67 inward patients in Teaching Hospital, Karapitiya and District General Hospital, Matara with peri-orbital contusions following trauma during a period of six months from January 2020 to June 2020. Results: A total number of 67 patients were included with 81% being male patients. The commonest soft tissue injuries around the PCs were abrasions (n=39, 71%) and 25 (38%) of the study sample had fractures of the skull. The majority (n=22, 88%) of them had fractures of facial bones followed by vault and basal skull fractures. The majority of PCs (45%) were blue in colour and only 8% were red. The red colour was observed only in PCs of less than 24 hours. The main cause for PC was due to direct blow to the eye while the rest (n=29, 45%) were due to the indirect blow. A higher incidence of fracture of the head was observed in assaults (39%). Conclusions: The commonest cause for the black eye in the study sample was the direct blow with a blunt force in an assault. The red colour was observed in PC of less than 24 hours duration. The PC had not caused major injuries to the eye but there was frequent involvement of facial bone fractures.