Blowout Fracture: The Daily PANCE Blueprint

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Blowout Fracture: The Daily PANCE Blueprint

An 18-year-old male is struck in the right eye with a baseball. He is taken to the ER via EMS. He is complaining of severe pain in his eye, double vision, and trouble looking up. On exam you notice exophthalmos, peri-orbital edema, and blood in the anterior chamber. What is the best management option for this patient?

A. Emergent ophthalmologist consult
B. Ice packs and cold compresses
C. Zygomatic arch x-ray
D. Start IV fluids and antibiotics
E. Fluorescein staining and x-ray

Answer and topic summary

The answer is A. Emergent ophthalmologist consult

Orbital floor fracture (blowout fracture) occurs when the orbital contents are traumatically forced through a fractured orbit floor. It usually occurs due to blunt trauma. Clinical features include proptosis, peri-orbital pain / edema, epistaxis, impairment of ocular movement, loss of sensation in the area (due to damage to the infraorbital nerve), and impaired visual acuity. CT is the best diagnostic test. Management includes immediate ophthalmologic consultation.

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Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint EENT ⇒ Disorders of the Eye ⇒ Traumatic disorders => Blowout fracture

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