The loose orbital fat may then fall back into place covering the bone defect, acting as a ball valve, trapping the air, and creating an acute orbital compartment syndrome with blinding potential. If the suspected affected side seems normal based on radiographic imaging findings, consider contralateral exophthalmos. If clinical photographs support a change in appearance, but the MRI findings are interpreted as normal, be sure the MRI was performed with fat saturation or suppression technique. Consider CT scan as well. Missed associated disease Orbital fractures frequently are associated with posttraumatic optic neuropathy, especially with blows to the mid glabella and lateral brow.
Prompt recognition is essential.
Red light desaturation, bright light desaturation, or the presence of a relative afferent pupillary defect is suggestive of the diagnosis in the setting of trauma. Negative sinus pressure and normal predisease imaging in silent sinus syndrome. Linear scleroderma in children. I. The anatomy of the ligament sling and its relation to intramuscular cone orbital fat. A cause of spontaneous enophthalmos.