Diagnosis and imaging of orbital roof fractures: a review of the current literature.

Isolated adult orbital roof fractures are uncommon, and the majority of them are typically associated with extensive craniofacial, ophthalmologic, and other body injuries. It is crucial to make an appropriate diagnosis of orbital roof fracture if present. Therefore, the aim of this article was to review the current literature about diagnosis and imaging of orbital roof fracture to obtain current indications. A systematic review of articles published between January 1990 and August 2013 was performed. Early diagnosis of orbital roof fractures can reduce the incidences of intracranial and ocular complications. CT scan still plays a major role in the assessment of acute orbital trauma. Careful assessment and reporting of the CT scan findings are important. In fact, the clinicians managing the patient with acute head and facial trauma should be familiar with the common findings of CT scan in case of an orbital roof fracture.

Diplopia and driving: a problematic issue.

The aim of this article was to review the literature regarding diplopia and driving license and to review the West European legislations about this topic, in order to obtain appropriate indications for hospitals specialists and patients. A systematic review of articles published about diplopia and driving was performed. In addition a review of West European national legislations about driving license regulations for medical illnesses was performed, in addition to the European Union Directive on driving licenses. In the literature, the presence of diplopia has not been considered a reliable predictor of the safety of driving behavior, or it has not appeared to be a contraindication for driving according to some authors who were unable to demonstrate significant differences on driving simulator performance between subjects with chronic stable diplopia and control subjects. Nevertheless, in all western European legislations, acute diplopia constitutes an important limitation for driving, thus making the knowledge of current regulations fundamental for specialists involved in managing patients with diplopia. Ophthalmologists and maxillofacial/head and neck surgeons, may advise patients before hospital discharge about current legislations in their respective countries.