Orbital Blow-out Fracture

The image shows a left-sided orbital floor fracture with teardrop sign (arrow). Click on the x-ray to enlarge.

Clinical suspicion of an orbital blow-out fracture (e.g. diplopia or reduced eye movements) merits urgent referral to a maxillofacial surgeon and/or an ophthalmologist.

Although plain x-ray may reinforce suspicion, facial CT scan will be needed to visualise the fracture in detail and plan surgical repair.

There is no evidence to support routine antibiotic prophylaxis in orbital floor fracture and local guidance should be followed [17].