Question:medium
A patient presented with history of diplopia and restricted eye movements. A clinical image and CT image is shown below. What will be the diagnosis?
A patient presented with history of diplopia and restricted eye movements. A clinical image and CT image is shown below. What will be the diagnosis?
Show Hint
Diplopia plus restricted gaze after blunt eye trauma equals orbital floor injury.
Updated On: Jun 23, 2026
- Le Fort fracture
- Fracture maxilla
- Fracture zygomatic
- Blow out fracture
Show Solution
The Correct Option is D
Solution and Explanation
Step 1: Link the clinical clues - blunt periorbital trauma producing double vision and a globe that cannot move fully.
Step 2: When an object wider than the eye socket strikes the orbit, pressure transmits to the weakest point and fractures the orbital floor or medial wall; this is a blowout fracture.
Step 3: The inferior rectus muscle and orbital fat herniate into the maxillary sinus and become trapped, mechanically limiting eye movement (especially elevation) and causing the diplopia seen in this patient. CT shows the floor defect and the tear-drop soft tissue herniation.
Step 4: Other options do not fit: $\text{Le Fort}$ injuries are higher midface fracture patterns, while isolated maxillary or zygomatic fractures lack the muscle-entrapment diplopia. The picture is diagnostic of a blowout fracture.
\[\boxed{\text{Blow out fracture}}\]
Step 2: When an object wider than the eye socket strikes the orbit, pressure transmits to the weakest point and fractures the orbital floor or medial wall; this is a blowout fracture.
Step 3: The inferior rectus muscle and orbital fat herniate into the maxillary sinus and become trapped, mechanically limiting eye movement (especially elevation) and causing the diplopia seen in this patient. CT shows the floor defect and the tear-drop soft tissue herniation.
Step 4: Other options do not fit: $\text{Le Fort}$ injuries are higher midface fracture patterns, while isolated maxillary or zygomatic fractures lack the muscle-entrapment diplopia. The picture is diagnostic of a blowout fracture.
\[\boxed{\text{Blow out fracture}}\]
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