Introduction
Blunt trauma to the anterior aspect of the eye may cause bruising, and an expansion of the eye which damages the muscles and fractures the orbital floor.
Dead Giveaways
Floor Fracture:
Giveaway is in the eye movements and CT-scan, where the bone is evidently broken
Infraorbital nerve anaesthesia causes cheek numbness
Orbital Haemorrhage:
Blood accumulation in the retrobulbar
Increases intraorbital pressure which can lead to ischaemia of the optic nerve
Shows the retrobulbar hamoerhage, leading to proptosis
diagnostic features
Floor Fracture:
Periocular oedema and ecchymosis (black eye)
Diplopia and enophthalmos
Subcutaneous emphysema (crackling noise)
Orbital Haemorrhage:
Presents with oedema and chemosis
Proptosis
Reduced vision and RAPD
Ocular motility disorders
Can somtimes present with an increase in IOP and disc swelling
Tx:
Immediate referral is needed for depressurisation of the orbit
Delayed treatment = poor prognosis