Blow-out fracture of orbit - External and Internal Eye
Synopsis
Patients often present with pain and tenderness to the periorbital region, which may worsen on attempted upgaze. They may note diplopia if there is limited motility of the involved eye. Signs of orbital floor blow-out fracture may include ecchymosis, enophthalmos, hypesthesia of the cheek, crepitus, and restricted eye movements, particularly in upgaze.
As the swelling decreases with time after the trauma, enophthalmos becomes more apparent in larger fractures. In many orbital fractures, swelling and ecchymosis are the only signs.
Pediatric Patient Considerations:
Children are at an increased risk of severe muscle entrapment of the inferior rectus with associated nausea and vomiting. This type of entrapment is considered a surgical emergency, as the tissue can become ischemic if not released.
Codes
S02.30XA – Fracture of orbital floor, unspecified side, initial encounter for closed fracture
S02.30XB – Fracture of orbital floor, unspecified side, initial encounter for open fracture
SNOMEDCT:
263167007 – Blow out fracture of orbit
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