Isolated Medial Orbital Wall Fracture: A Rare Presentation

Abstract

Aim: The aim of this study was to evaluate the clinical course and treatment of a case that developed right orbital medial wall fracture following the rare etiological factor of nose blowing. Presentation of Case: A 20-year-old male patient presented with suddenly developing swelling of the right eye following strong nose blowing the same day. The examination revealed swelling of the right eye and mild pain with eye movements. The visual acuity was full with normal anterior and posterior segments in both eyes. Computed tomography revealed an ethmoid bone fracture and medial rectus muscle and orbital contents had prolapsed inside the sinus. The eyelid swelling had decreased and the pain with eye movements had disappeared at the 2-week follow-up. Complete recovery without any sequel was seen in the 3-month follow-up. Discussion: Considering the complications that may develop after surgical treatment, the cases should be thoroughly evaluated at presentation with surgery only being considered in appropriate cases. Small fractures with no or minor herniation, or cases with diplopia recovering quickly can be monitored without treatment. Our patient was followed-up without treatment as the bone defect was small, and there was no enophtalmus, eye movement limitation or diplopia. Full recovery was seen without sequel at the end of the short-term follow-up of our patient. Conclusion: Small fractures with no enophtalmus, eye movement limitation or diplopia can be followed-up without treatment, as in the presented case.