A direct blow to the eye or cheekbone (ball, punch, fall) can fracture the thin walls of the orbit — most often the floor. The eye itself must always be examined after such trauma.
The signs
Eyelid swelling and bruising, double vision (diplopia) especially when looking up, a sunken eye (enophthalmos) sometimes appearing late, tingling of the cheek (infraorbital nerve). Avoid blowing your nose: air from the sinuses can inflate the orbit.
The work-up
A full eye examination — ruling out injury to the eyeball is the priority — then an orbital CT scan. In children, the "trapdoor" fracture with muscle entrapment is a special case: it requires prompt surgical management.
The treatment
Many fractures only require simple monitoring. Surgical repair of the floor (placement of a plate) is considered for persistent diplopia or significant enophthalmos. In case of muscle entrapment, surgery must be performed as an emergency.
Frequently asked questions
Why shouldn't you blow your nose?
The fractured walls connect the orbit with the sinuses: blowing your nose can push air into the orbit (emphysema) and worsen the swelling. Refrain for a few weeks, until your surgeon agrees.
Book an appointment
Consultations in Boulogne-Billancourt (Ophtalife) and Saint-Maur-des-Fossés (Beaurepaire).