Orbital blow-out fracture, ocular lens dislocation, and retrobulbar hemorrhage

Case contributed by Shervin Sharifkashani
Diagnosis certain


Facial trauma and subsequent orbital pain, proptosis, and decreased visual acuity on the left side.

Patient Data

Age: 60 years
Gender: Female

Left orbital medial wall blow-out fracture with fat and partially herniated medial rectus muscle within the fracture gap, intraconal and retrobulbar hemorrhagic foci encased the related extraocular muscles and optic nerve sheath complex, mild cornea and uveo-scleral tear, ocular lens dislocation, and proptosis are seen. Left maxillary sinus hemorrhage is seen. Preseptal and lacrimal gland soft tissue swelling is noted.

Case Discussion

The case illustrates the non-contrast MDCT features of orbital blow-out fracture, retrobulbar hemorrhage, and ocular lens dislocation due to blunt facial trauma. Retrobulbar hemorrhage needs close follow-up and must be carefully managed. Proptosis is one of the major indications for emergent decompression of the hemorrhage 1.

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