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Blowout fracture of the orbit

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

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

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