Citation

Hammond D, Grew N, Khan Z. J. Surg. Case Rep. 2013; 2013(7): rjt054.

Affiliation

Department of Oral and Maxillofacial Surgery, New Cross Hospital, Wolverhampton, UK.

Copyright

(Copyright © 2013, Oxford University Press)

DOI

10.1093/jscr/rjt054

PMID

24964459

Abstract

Inferior 'trapdoor' orbital floor fractures with muscle and soft tissue incarceration are the most common type of orbital fracture in children. Delays to treatment can lead to a significant morbidity. It has been recommended that children who present with a 'white-eyed blowout' fracture should have surgery performed within 48h of diagnosis, otherwise prognosis is poor. A 14-year-old boy was initially misdiagnosed with a head injury due to the minor appearance of his orbital injury and his presenting complaint of nausea and vomiting. This resulted in a significant delay to surgery. The oculovagal reflex associated with orbital injuries is well documented (Wei and Durairaj in Pediatric orbital floor fractures. J AAPOS 2011;15: :173-80). It should be considered by emergency department and paediatric staff when dealing with patients who have sustained a blow to the orbital region, despite not having a subconjunctival haemorrhage. The importance of examination to detect other features of orbital blow-out and entrapment are stressed.

Language: en