orbital fracture (blowout fracture)

Etiology

• direct trauma to the orbit

Pathology

• entrapment of inferior rectus muscle results in restricted elevation of eye
• enopthalmus when orbital contents displaced into maxillary sinus
• edema generally resolves in 7-10 days

Clinical manifestations

• diplopia, especially upward or downward gaze
• gaze palsy, inability to look upward
• numbness in distribution of ipsilateral maxillary nerve may be present
• subconjunctival hemorrhage
• periorbital edema
• ipsilateral nose bleed
• symptoms may resolve with resolution of edema in 7-10 days

Radiology

• CT of orbit
• CT of skull base

Differential diagnosis

• eye injury

Management

• assess extraocular muscle motility
• observation for 7-10 days prior to surgery, unless otherwise indicated
• intranasal decongestants
• avoid blowing nose
• antibiotics for sinusitis frequently given

More general terms

• skull fracture (cranial fracture)

More specific terms

• orbital floor fracture; blowout fracture
• orbital fracture, other than floor (blowout fracture)

Additional terms

• eye injury/trauma