A boy presents with diplopia and restriction of eye movements following blunt trauma to his eye. X-ray reveals blow out fracture of orbit. Which part of orbit is most likely damaged :
Ans- B Floor of the orbit Ref - Traumatic injuries usually caused by sports and interpersonal violence. In children, play and accidents are the most common causes. Definition The orbit is one of a pair of bony cavities each housing the globe and associated structures. The orbit is formed by 7 bones: zygomatic, sphenoid, maxillary, frontal, lacrimal, palatine, and ethmoid. Fractures of the orbit may be seen in different scenarios of direct and indirect trauma to the globe, orbital, facial, or cranial bones. The most common presentation of orbital fractures is associated with zygomatic complex fractures (i.e., involving the cheek bone and thus the lateral orbital wall). Weakest wall of the orbit is the FLOOR Explanation: Although the bone of the medial orbital wall is thinnest, the medial wall is strengthened by the perpendicular septa of the ethmoid sinuses. The floor of the orbit is most vulnerable to fracture when there is a direct force exerted on the ocular globe because it is thin and unsupported. The weakest point of the orbit is the posteromedial aspect of the floor - the MC site of blow-out fracture History and exam Key diagnostic factors diplopia on upward gaze derangement of globe position intercanthal distance increased oculovagal symptoms (bradycardia, hypotension, nausea/vomiting) Full details Other diagnostic factors visual disturbance periorbital ecchymosis periorbital edema nerve sensory loss Full details Risk factors young adults and children male gender Full details Diagnostic investigations 1st investigations to order x-ray of the face CT scan of the orbit Full details Investigations to consider MRI of the orbit forced duction test orthoptic test Full details Emerging tests ultrasonographic orbital scanning Full details Traumatic injuries usually caused by sports and interpersonal violence. In children, play and accidents are the most common causes. Definition The orbit is one of a pair of bony cavities each housing the globe and associated structures. The orbit is formed by 7 bones: zygomatic, sphenoid, maxillary, frontal, lacrimal, palatine, and ethmoid. Fractures of the orbit may be seen in different scenarios of direct and indirect trauma to the globe, orbital, facial, or cranial bones. The most common presentation of orbital fractures is associated with zygomatic complex fractures (i.e., involving the cheek bone and thus the lateral orbital wall). The most common intraorbital fracture is the medial wall "blowout" fracture. History and exam Key diagnostic factors diplopia on upward gaze derangement of globe position intercanthal distance increased oculovagal symptoms (bradycardia, hypotension, nausea/vomiting) Full details Other diagnostic factors visual disturbance periorbital ecchymosis periorbital edema nerve sensory loss Full details Risk factors young adults and children male gender Full details Diagnostic investigations 1st investigations to order x-ray of the face CT scan of the orbit Full details Investigations to consider MRI of the orbit forced duction test orthoptic test Full details Emerging tests ultrasonographic orbital scanning Full details
Superior wall
Floor of the orbit
Lateral wall
Medial wall