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Motor vehicle accident months earlier.
Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.
From the case:
Orbital blow-out fracture - medial
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This patient suffered a direct blow to the left orbit during a motor vehicle accident some months earlier. This resulted in a medial blow-out fracture through the lamina papyracea into the middle ethmoidal air-cells with extrusion of orbital fat, but no extraoccular muscle entrapment.