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Medical Photograph Library
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Wednesday, August 20, 2008
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Fracture
of the lower bones of the eyesocket (Direct or true blow-out fracture
of the orbital floor) . A 17-year-old man came to the Emergency
Department with a 3-day history of double vision when looking
up after having been struck in the right eye with a clenched fist.
A direct blow-out fracture occurs when all the energy that causes
the injury is transferred through the globe (eyeball). The blood
below the skin surrounding the eye, swelling, blood over the white
of the eye, and the inability of the patient to look upward (patient
is shown looking up) are suggestive of a fracture of the bottom
bone of the eye socket (orbital floor) with entrapment of the
eye. Other things that a physican may observe when examining a
patient with an orbital floor fracture include decreased ability
to see, bleeding from the nose, and pain/tingling in the area
below the eye. A computerized tomography
(CT) of the eye and surrounding structures demonstrate blood
in the sinus below the injured eye (right maxillary sinus) and
eye itself lying down through a defect in the orbital floor. A
CT of the orbits is indicated when there is evidence of entrapment
of the orbital contents on examination (inability to look upward).
(L.S.)
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