Blow out fracture

Question 1

General

Answer 1

Caused by orbital trauma

mechanism = force of blow - backward displacement of eye - Raised IOP - Fracture of the weakest part of the orbit

Question 2

Clinical findings

Answer 2

Endopthalmitis

Orbital enphysema

Macular region numbness

Hypoglobus

Question 3

Inferior Blow out

Answer 3

Most common

orbital flap prolapse into macillary sinus

medial rectus prolapse

50% joined with medial wall fracture

Question 4

Medial Blowout

Answer 4

occurs through laminate papricia

orbital flap + medial rectus may prolapse into ethmoid air cells

Question 5

Superior Blowout

Answer 5

Pneumatisation of the orbit roof

any communication with anterior cranial fossa at risk of CSf leak and therefore meningitis

Question 6

Lateral Blowout

Answer 6

Rare

Fractures the orbital rim

Question 7

Clinical examinations

Answer 7

Visions

Motility

Colour vision

Fields

Cover test

Fusion

Ocular exam

Question 8

Indications of surgery

Answer 8

Significant endopthalmitis

Sig Diplopia

Muscle entrapment with trapdoor in children

Large area of fracture