Orbital Blow Out Fracture Flashcards
What causes an orbital blow out fracture?
Hitting the front of the eye with force - sudden increase in intra orbital pressure from retropulsion of eye ball by fist or ball
What part of the orbit fractures?
The floor
Describe the presentation
History of trauma to eye Periorbital swelling and pain Double vision especially on vertical gaze Impaired vision Anaesthesia over affected cheek
Why can you get anaesthesia over affected cheek?
Infraorbital nerve (branch of maxillary division of trigeminal) runs through floor of orbit to innervate cheek and lower eyelid
When you ask patient to look up they are unable to. Why is this?
The fracture traps the extra orbital muscle located near the floor of the orbit - anchoring the eye to the floor
What signs can be seen on X-ray, showing pro lapsing tissue through the floor of the orbit?
Teardrop sign
Other than the teardrop sign, what else can be seen on X-ray with a blow out fracture?
Fluid level - blood in the the maxillary sinus
What early treatment should be done?
Nasal decongestants Prophylactic antibiotics Avoid blowing nose Avoid driving until diplopia resolves Ice pack for 1-2 days
Other than the immediate treatment, how else should the fracture be managed?
Ophthalmology referral
Surgical repair if necessary
