Orbital floor fracture

What it is

The orbital floor is the weakest bone of the orbit, so it is the one that gives way in ocular trauma. The inferior rectus gets trapped and the infraorbital nerve is injured.

Children are prone to a greenstick fracture, which results in ischaemia and the oculocardiac reflex.

How it presents

There is a history of injury, with no reduction in vision unless the globe or the optic nerve are injured. Periocular ecchymosis with no proptosis after a blow to the eye is the picture.