Break the Fall: Orbital Blowout Fracture

Background: Head trauma can lead to multiple ocular complications, among the most concerning is an orbital blowout fracture. Common associations with an orbital fracture would include periorbital ecchymosis, subconjunctival hemorrhage, eyelid edema, and crepitus, among others. Concerning complications, such as retinal detachment, need to be ruled out at the time of presentation. Surgical intervention may be warranted in certain cases. An emergent head computed tomography scan must be performed to evaluate and determine management. Case Report: This case features a 66-year-old Caucasian male with an orbital blowout fracture following a fall. In addition to discussing the details regarding this patient’s case, this report highlights fracture types, pertinent imaging, determination of muscle entrapment, and other underlying complications. Conclusion: Careful evaluation is critical in proper management of potential orbital fracture cases. Entrance testing such as visual acuity measurement, pupil assessment, and extraocular muscle motility evaluation provide useful information regarding suspected severity of an orbital fracture. A dilated fundus examination is necessary for assessing concerning posterior complications. Computed tomography imaging must be obtained in all instances of questionable orbital fracture. Surgical intervention may be needed in some instances. Regardless of the necessity for surgical intervention, careful monitoring of these cases for resolution is advisable.