White eyed blow out fracture: an easily overlooked finding

¹Department of Oral and Maxillofacial Surgery, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Medical Sciences (Deemed to be university), Wardha, India

^&Corresponding author
Aishwarya Ashok Gupta, Department of Oral and Maxillofacial Surgery, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Medical Sciences (Deemed to be university), Wardha, India

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A 35-year-old systemically healthy countryside male presented to the emergency department with a complaint of pain over the left side of his face following a road traffic accident. Clinical examination revealed discontinuity and tenderness over the left infraorbital region, restrictive superior and superolateral gaze, and binocular diplopia with the left eye without periorbital edema or subconjunctival hemorrhage (A). The computed tomogram (CT head) confirmed the left orbital floor fracture with muscle entrapment (B). The diagnosis of white-eyed blow-out fracture was established and scheduled for release of the entrapped muscle with orbital floor reconstruction under general anesthesia. The exhibited report is unique as this phenomenon is commonly observed in the pediatric population and is considered a rarity in adults. This may be attributed due to the high resiliency of bone due to incomplete mineralization causing minimal injury to the investing soft tissue, resulting in a characteristic absence of edema and hemorrhage.

Figure 1: A) restriction of left eyeball on upward movement; B) herniation of orbital content with tear-drop appearance