A patient sustains a blunt facial trauma and presents with enophthalmos, infraorbital hypoesthesia, and restricted upward gaze. The most likely diagnosis is:
- A Zygomaticomaxillary complex fracture
- B Nasal bone fracture
- C Orbital blowout fracture (floor fracture with inferior rectus entrapment) ✓
- D Le Fort III fracture
Correct answer: C. Orbital blowout fracture (floor fracture with inferior rectus entrapment)
Explanation
Orbital blowout fracture involves the orbital floor (most commonly) without the orbital rim. Increased intraorbital pressure from blunt trauma causes the thin orbital floor to fracture, potentially entrapping the inferior rectus or orbital fat. Clinical findings include: restricted upward gaze (inferior rectus entrapment), enophthalmos (orbital volume increase from floor herniation), and infraorbital hypoesthesia (infraorbital nerve traverses the orbital floor). Urgent surgical repair is needed for 'white-eyed blowout' in children due to muscle ischemia from entrapment.
Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.