Imaging Case of the Week 467 Answer

The coronal CT face image shows ‘tear drop sign’.

There is a left orbital floor fracture displaced inferiorly together with inferior rectus muscle.

The orbital blowout fracture is a s a result of direct impact to the orbit. Patient may present with bruising/swelling around the affected eye, visual disturbance, double vision, altered sensation on the cheek.

Clinical signs to assess for –

  • Periorbital swelling/bruising.
  • Diplopia of vertical gaze due to inferior rectus herniation.
  • Hypoglobus (lowered pupillary line)
  • Enophthalmos due to ptosis of orbital contents into maxillary antrum.
  • Proptosis.
  • Parasthesia in the distribution of infraorbital nerve.
  • Visual acuity & pupillary assessment (traumatic optic neuropathy)

The above patient was referred to the specialist and underwent surgical management.

Reference: floor fractures