Monday, July 14, 2008


A 20 year old is hit in the eye by a baseball. On exam, you find enophthalmos (the eye is receded into the orbit). The eye on the affected side is lower in the horizontal plane than the other side. When you have the patient look up and left, you see this:

You get a coronal CT, shown below:

Challenge: What happened?

Images shown under fair use.


tree said...

blowout fracture

Craig said...


This is an orbital floor fracture, also known as a blowout fracture. It can lead to entrapment of the inferior rectus and/or orbital fat. This causes the orbital dystopia (affected eye is lower than the other eye). The inferior nerve palsy is due to entrapment of the inferior rectus. This is confirmed by the CT.

Sources: UpToDate, original photo courtesy of Mark Neuman;