Diplopia as an alarm sign in orbital traumatism
Eduardo Esteban-Zubero, Kevin Verney Lafont-Jiménez, Cristina García-Muro, Moisés Alejandro Alatorre-Jiménez, Alejandro Marín-Medina, Carlos Arturo López-García, Daniela Delgado Lara, Viridiana Ramírez Ramírez
Journal Title:International Medicine
Orbital fractures represent between 10% and 25% of all facial fractures. They may be classified into three types: a) orbital rim fractures, b) comminuted fractures of the orbital wall (the most frequently observed), and c) "trap door" fractures of the orbital wall. This pathology is more relevant in traffic accidents due to its greater complexity given the appearance of concomitant injuries. The most frequent clinical signs observed in adults in orbital fractures are periorbital ecchymosis and subconjunctival hemorrhage, although symptoms related to proptosis, feeling of orbital or eyelid pressure, a "crackling" sound with the eyelid pressure or eye movement, numbness of the cheek, nasal wing or ipsilateral forehead, diplopia, pain or nausea in a particular direction of the gaze, and an unexplained desire to keep the eye closed after a trauma. The standardized diagnostic method for the diagnosis of orbital fractures is the computerized axial tomography (CT), being ultrasound and cone beam CT equally useful in some cases. Attending to the treatment, conservative management may be performed, requiring surgery within two weeks if persistent diplopia is found, enophthalmos >2 mm, orbital floor fracture >50%, or associated fractures which requires surgery. Hereby, we realize a short review of orbital fractures a purpose of a case report of 85-year-old man which suffered a left hemifacial traumatism. A CT was performed showing a fracture of the floor of the left orbit (left maxilla) with signs of entrapment of the left inferior rectus muscle.