UMEM Educational Pearls

Category: Neurology

Title: Ophthalmic and Neurologic Findings with Orbital Floor Fractures

Keywords: orbital floor fracture, neuropathy (PubMed Search)

Posted: 5/14/2008 by Aisha Liferidge, MD (Updated: 10/21/2021)
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  • Fractures of the orbital floor typically result from direct, blunt trauma with a rounded object to the eye. 
  • When describing associated ophthalmic and/or neurologic injury, to consultants in particular, be aware of appropriate terminology to use in relaying the presence or absence of related physical findings.
  • The following ophthalmic abnormalities are commonly associated with orbitla floor fractures:

              -- Enophthalmos (eye receded into the orbit) may occur when globe is 

                  displaced posteriorly, often with prolapse of tissue into maxillary sinus.

              -- Orbital dystopia (affected eye in a  lower horizontal plane than the other) may

                  occur due to the pulling of entrapped muscle and orbital fat.

  • Remember to check for facial sensation, as decreased sensation along the ipsilateral cheek, upper lip, or upper gingiva suggests injury to the infraorbital nerve.
  • The presence of a teardrop-shaped pupil suggests that the globe ruptured.