Rosli Abdul-Hadi, Nordin Mohd-Hudzaifah, Embong Zunaina, Wan Hitam Wan-Hazabbah
MD (UKM), MMED (Ophthal) (USM), Department of Ophthalmology Kulliyyah of Medicine, International Islamic University Malaysia, Bandar Indera Mahkota, Kuantan, Pahang, Malaysia.
Department of Ophthalmology and Visual Science, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kelantan, Malaysia.
Malays Fam Physician. 2022 Jan 25;17(1):78-81. doi: 10.51866/cr1150. eCollection 2022 Mar 28.
A white-eyed blowout fracture is an orbital floor fracture associated with restriction of ocular motility (suggestive of orbital content entrapment) but with minimal or absence of signs of soft tissue trauma. It can lead to significant patient morbidity. This case involved an 8-year-old boy with a white-eyed blowout fracture following facial trauma. He presented with binocular diplopia and a history of recurrent episodes of vomiting after the trauma and was referred to our centre for a suspected head injury. Visual acuity in both eyes was 6/9. Examination showed minimal left periorbital haematoma with left eye motility restriction on superior and medial gaze associated with pain. CT scan of the orbit showed left orbital floor fracture with minimal soft tissue entrapment. He underwent urgent open exploration of the left orbit and release of orbital tissue entrapment. Post-operatively, the left eye motility restriction improved significantly with resolution of diplopia. In conclusion, a high index of suspicion is crucial in diagnosing paediatric white-eyed blowout fractures due to lack of external ocular signs.
白眼爆裂性骨折是一种眶底骨折，伴有眼球运动受限（提示眶内容物嵌顿），但软组织创伤体征轻微或无明显体征。它可导致患者出现明显的发病情况。该病例为一名8岁男孩，面部外伤后发生白眼爆裂性骨折。他出现双眼复视，外伤后有反复呕吐史，因疑似头部受伤被转诊至我们中心。双眼视力均为6/9。检查发现左侧眶周有轻微血肿，左眼在上视和内视时运动受限并伴有疼痛。眼眶CT扫描显示左侧眶底骨折，软组织嵌顿轻微。他接受了紧急的左侧眼眶开放探查及眶内组织嵌顿松解术。术后，左眼运动受限明显改善，复视消失。总之，由于缺乏眼部外部体征，高度怀疑对于诊断儿童白眼爆裂性骨折至关重要。
