Proper Imaging Modality in Medial Orbital Wall and Blowout Fracture

Abstract

A 27-year-old man was first seen 4 weeks after his right eye being accidently hit by branches of tree. He complained of diplopia which was significant on the right gaze. There were partial thickness superior and inferior eyelid rupture and full thickness superior eyelid margin laceration (which got repaired), hematoma, and swelling of the right eye. Orbital x-ray demonstrated no abnormality. However, orbital CT Scan was eventually obtained and it showed medial wall and orbital floor fracture of the right eye, hence, we planned to do the reconstruction of orbital fracture. We concluded that patient with severe soft tissue swelling, unclear ocular movement restriction and diplopia with normal orbital X-ray should undergo orbital CT scan, as it is the best radiologic imaging in establishing an orbital wall fracture. This case report will discuss the importance on determining a proper imaging modality in blowout fracture.