New research suggests that patients with orbital fracture are at higher risk of dry eye compared with the general population.

The investigation included patients from the Taiwan National Health Insurance Research Database. Overall, 46,179 and 184,716 participants comprised the study and control groups, respectively. Each patient in the case group was age- and gender-matched to four controls without orbital fracture.

The team found that during the follow-up period, the case group was more likely to develop incident dry eye (0.17%) than the control group (0.11%). Statistical analysis demonstrated that the case group had an almost fivefold increased risk of dry eye compared with controls.

When stratified by age group, the data showed that orbital fracture was most common among patients aged 18 to 29 years. Specifically, patients with orbital roof fracture had the greatest risk of developing dry eye. Regardless of receiving surgery or not, the patients with orbital fracture had a higher risk of developing subsequent dry eye.

 “One plausible explanation for our observation was that the rate of DES occurrence following the orbital fracture was attributed to lacrimal gland injury,” the authors wrote in their study. Given that the lacrimal gland is located in the superolateral aspect of the orbit, “this suggests that the anatomical disruption and mechanical compression from orbital trauma contributed to the resulting injury of the lacrimal gland, including hematoma, edema and vascular insufficiency.”

Early recognition of orbital fractures with lacrimal gland involvement with raised awareness in the clinical setting “could preserve visual function and prevent further complications,” the study authors concluded.

Hsu CYY, Tu JCY, Chung CH, et al. Risk of dry eye syndrome in patients with orbital fracture: a nationwide population-based cohort study. Healthcare (Basel). 2021;9(5):605.