Orbital blowout fracture

Orbital blowout fracture refers to a type of facial trauma involving a fracture of the bones surrounding the eye socket or orbit, without damage to the rim of the orbit. This condition often results from an impact to the soft tissue of the eye, such as being hit by a ball or fist, which transmits force to the bones of the orbit, causing them to break and potentially leading to entrapment of the inferior rectus muscle or inferior oblique muscle, which can affect eye movement.

Causes

Orbital blowout fractures are commonly caused by blunt trauma to the orbit. This can occur during sports, physical altercations, falls, or vehicle accidents. The force of the impact causes a sudden increase in intraorbital pressure, leading to a fracture of the weakest point of the orbit, typically the orbital floor or medial wall.

Symptoms

Symptoms of an orbital blowout fracture may include:

• Visual disturbances
• Pain, especially with eye movement
• Swelling and bruising around the eye (periorbital ecchymosis)
• Double vision (diplopia)
• Numbness or decreased sensation in the cheek and upper lip due to damage to the infraorbital nerve
• Enophthalmos (sunken appearance of the eye)

Diagnosis

Diagnosis of an orbital blowout fracture is primarily based on the patient's history and clinical examination. Imaging studies, such as a CT scan, are crucial for confirming the diagnosis and assessing the extent of the fracture and any involvement of the eye muscles.

Treatment

Treatment of orbital blowout fractures depends on the severity of the fracture and the presence of any complications, such as muscle entrapment. Options include:

• Observation and monitoring for cases without significant symptoms or risk of muscle entrapment
• Surgery to repair the fracture and release any entrapped muscles for patients with significant symptoms, muscle entrapment, or cosmetic concerns

Complications

Complications of orbital blowout fractures can include persistent double vision, infection, and changes in the position of the eyeball within the orbit (enophthalmos or exophthalmos).

Prevention

Prevention of orbital blowout fractures involves the use of protective eyewear during activities that pose a risk of facial trauma, such as certain sports and occupations that involve the risk of flying debris or falls.

See also

• Facial trauma
• Eye injury
• Maxillofacial surgery