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Eye Socket Disorders

Blow Out Fracture

A blowout fracture is a fracture of the floor (or wall) of the orbit (eye socket). This is caused by trauma to the eye with a blunt object such as a fist, knee or cricket ball. The force of a blow distorts the orbit and raises pressure within it.

The raised pressure causes thin bone of the floor (or medial wall) to blowout and fracture. This may result in structures in the orbit protruding into the surrounding sinuses. If the muscles which move the eye are caught in the fracture the eye would move with the other eye resulting in diplopia (double vision). If large, the eye may sink back and down (enophthalmos). Investigation is with a CT scan X-ray.

Blow Out Fracture


Treatment usually involves observation for one week till swelling settles, then assessing for diplopia or enophthalmos. Noseblowing should be avoided as air may be forced via the sinuses and fracture into the orbit. This results in sudden swelling of the eyelids. This can be distressing but settles over a few days.

If diplopia or enophthalmos is present and significant after one week, then an implant is used to rebuild the orbital floor and or wall. A general anaesthetic is required for this surgery and usually one night in hospital for observation. Surgery should be done within 2 weeks for best results.

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