A study from North Carolina University shows that the prognosis for horses with fractured orbital bones is generally good but depends on the extent of the damage.

Researchers reviewed the records of 18 horses seen at the university clinic for orbital fractures from 2006 to 2013. Causes of the injuries included rearing in a small space, being kicked or colliding with a stationary object. Fifteen of the study horses underwent surgery to stabilize the orbit.

The data showed that the majority of horses diagnosed with orbital fractures had a favorable prognosis for vision, return to function, and overall cosmesis. However, the prognosis depends on the type of injury and type of orbital fracture sustained. 

Horses sustaining fractures from direct kicks had an increased likelihood of ocular trauma, vision loss and eye removal. They also had a higher incidence of comminuted fractures affecting multiple bones. 

The researchers noted that horses with fractures caused by rearing in a confined space need to be evaluated for other concurrent injuries because these were more common with this type of trauma.

Other prognostic indicators include bleeding from the nose (epistaxis) and inflammation of the tissue lining the sinuses (sinusitis), which may be signs of more severe trauma that requires more aggressive treatment. All horses who had sinusitis and epistaxis sustained comminuted fractures affecting multiple bones or fractures of the zygomatic process of the temporal bone, which decreased the overall functional and cosmetic outcome. Sinus and skull radiography and computed0 tomography was effective at diagnosing orbital fractures as well as assessing sinus and nasal cavity involvement.

The researchers found that surgical therapy was usually successful in restoring function and appearance in horses with orbital fractures. Overall, they describe the prognosis for horses after such injuries as “favorable,” with 13 of the study horses returning to their previous use.

Reference: “Equine orbital fractures: a review of 18 cases (2006-2013),” Veterinary Ophthalmology, March 2014

This article first appeared in EQUUS issue #441.

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