A case of isolated medial wall fracture with medial rectus entrapment following seemingly trivial trauma.

A case of isolated medial orbital wall fracture and medial rectus entrapment is presented. With minimal external evidence of trauma and lack of definitive evidence of fracture on plain films, a high index of suspicion if needed to diagnose this relatively unusual syndrome. The triad of: (1) retraction syndrome; (2) positive forced ductions in abduction; and (3) radiographic evidence of medial wall fracture on polytomography, will help the clinician to properly diagnose this condition. Epistaxis and subcutaneous emphysema, when present, should alert one to look carefully for a medial wall fracture.