MCQ – 71148

A 28-year-old man involved in a road traffic accident sustained a blunt injury to his left eye. Clinically there was left periorbital swelling and bruising and examination of the extraocular eye movement showed impaired vertical gaze with associated diplopia. A CT of the orbit and brain was performed for further evaluation. Regarding this condition, which of the following can be a clinical presentation?

A.	Diplopia
B.	Paresthesia in distribution of inferior alveolar nerve
C.	Forced Duction test
D.	All of the above

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Correct Answer � D Explanation

Ans:D.)All of the above.

Image shows 

Coronal CT orbit show fractures of the floor of left orbit (arrows) with herniation of extraconal fat (arrowheads) and inferior rectus muscle (open arrow) into the roof of the left maxillary sinus. 

BLOW OUT FRACTURE OF ORBIT

• Blow out fracture is a fracture of orbital floor or medial wall.
• It presents with emphysema of lid, subconjunctival ecchymosis, diplopia & forced duction test (due to entrapment of muscle), epistaxis, proptosis, enophthalmos & paresthesia in the distribution of the inferior alveolar nerve.
• X-ray shows teardrop or hanging drop sign