blowout fracture of the orbit
Last reviewed 12/2022
Seek expert advice.
- direct impact on the orbit may elevate orbital pressure sufficiently as to fracture the thin medial and inferior walls
- the inferior rectus herniates into the maxillary sinus, is trapped, and impairs upgaze resulting in diplopia. Downgaze may also be affected. The eye may be sunken - enophthalmic - and there may be sensory loss corresponding to the area supplied by the infra-orbital nerve
- sinus x-rays may reveal bony defects, an air-fluid level in the sinus and herniated soft tissue. The lesion is preferentially visualised by tomography
- surgical repair is performed if the diplopia is unlikely to resolve spontaneously, there is severe enophthalmus, or the fracture is so large that the development of enophthalmus is likely