injuries poisoning
Eye Contusions and Lacerations
Blowout fracture
Blowout fracture occurs when blunt trauma forces the orbital contents through one of the most fragile portions of the orbital wall, typically the floor. Medial and roof fractures also can occur. Orbital hemorrhage can cause complications such as entrapment of the infraorbital nerve, lid edema, and ecchymosis. Patients may have facial or orbital pain, diplopia, enophthalmos, hypesthesia of the cheek and upper lip (due to infraorbital nerve entrapment or injury), epistaxis, and/or subcutaneous emphysema. Other facial fractures or injuries must also be ruled out. Diagnosis is best made using CT with thin cuts through the facial bones. If ocular motility is impaired (eg, causing diplopia), extraocular muscles should be assessed for signs of entrapment. If there is diplopia or cosmetically unacceptable enophthalmos, surgical repair may be indicated. Patients should be told to avoid blowing the nose to prevent orbital compartment syndrome from air reflux. Using a topical vasoconstrictor for 2 to 3 days may alleviate epistaxis. Oral antibiotics could be used if patients have sinusitis. 