A systematic approach to CT evaluation of orbital trauma

Aaron M. Betts, William T. O'Brien, Brett W. Davies, Omaya H. Youssef

Research output: Contribution to journalArticlepeer-review

23 Scopus citations


Computed tomography (CT) is widely used in the initial evaluation of patients with craniofacial trauma. Due to anatomical proximity, craniofacial trauma often involves concomitant injury to the eye and orbit. These injuries may have devastating consequences to vision, ocular motility, and cosmesis. CT imaging provides a rapid and detailed evaluation of bony structures and soft tissues of the orbit, is sensitive in detection of orbital foreign bodies, and often guides clinical and surgical management decisions in orbital trauma. For this reason, radiologists should be prepared to rapidly recognize common orbital fracture patterns, accurately describe soft tissue injuries of the orbit, detect and localize retained foreign bodies within the globe and orbit, and recognize abnormalities of the contents and integrity of the globe. In this review, we present a systematic approach to assist radiologists in the rapid evaluation of orbital trauma using the "BALPINE" mnemonic - bones, anterior chamber, lens, posterior globe structures, intraconal orbit, neurovascular structures, and extraocular muscles/extraconal orbit. Using this approach, we describe common traumatic findings within each of these spaces, and present common postsurgical appearances that can mimic findings of acute trauma.

Original languageEnglish (US)
Pages (from-to)511-531
Number of pages21
JournalEmergency Radiology
Issue number5
StatePublished - Oct 1 2014
Externally publishedYes


  • Computed tomography
  • Orbital foreign body
  • Orbital trauma

ASJC Scopus subject areas

  • Emergency Medicine
  • Radiology Nuclear Medicine and imaging


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