What's the most likely diagnosis?

• 22 year-old with diplopia

1. Nasal bone fracture
2. Retinoblastoma
3. Sinusitis
4. Cellulitis
5. Blowout fracture

Answer:

 

5. Blowout fracture

 

 

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Blowout Fracture of the Orbit

General Considerations

• Isolated fractures, most commonly of the orbital floor
• The cause is sudden, direct, blunt trauma in the form of a blow to the orbit with increase in intraorbital pressure
• The orbital rim is relatively strong so force is transmitted to the weakest parts of the orbit which “blow-out”
• Orbital floor which is the superior boundary of the maxillary sinus, or
• Medial wall (the thin lamina papyracea) which is the lateral boundary of the ethmoid sinus
• The nasal bone is also frequently fractured
• The cause is usually a large object such as baseballs, fists, automobile accidents, tennis balls and kicks

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