A blow out fracture occurs when there is trauma to the floor of the orbit. The trauma must exceed the tolerance of the bone. If this occurs with from a direct injury there is usually a naso-orbital fracture present as well. This is usually associated with blunt trauma and are often seen in motor vehicle accidents or an object striking the orbit. The symptoms of a orbital fracture are edema of the tissue lid, difficulty with vertical movement of the eye, or subcutaneous emphysema. A nose bleed could occur becuase of the connection with the maxilla and the nasal sinus. In severe cases of this fracture the orbit of the eye can actually drop into the maxillary sinus causing entrapment. This results in an inablitly to look superiorly or inferiorly. This can be corrected with surgery but if left unattended permnent stenosis of the muscle can occur. For diagnosis CT is the gold standard both axial and coronal scans should be obtained.
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