Last reviewed: October 2017
Last updated: September  2017

Summary

Definition

History and exam

Key diagnostic factors

  • diplopia on upward gaze
  • derangement of globe position
  • intercanthal distance increased
  • oculovagal symptoms (bradycardia, hypotension, nausea/vomiting)

Other diagnostic factors

  • visual disturbance
  • peri-orbital ecchymosis
  • peri-orbital oedema
  • nerve sensory loss
  • subconjunctival haemorrhage
  • step defect infra-orbital rim
  • loss of colour vision
  • impaired pupillary light reflex
  • decreased visual acuity

Risk factors

  • young adults and children
  • male gender

Diagnostic investigations

1st investigations to order

  • x-ray of the face
  • CT scan of the orbit
Full details

Investigations to consider

  • MRI of the orbit
  • forced duction test
  • orthoptic test
Full details

Emerging tests

  • ultrasonographic orbital scanning
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Consultant Oral and Maxillofacial Surgeon

South West Cleft Service

United Hospitals Bristol NHS Trust

Bristol

UK

Disclosures

ARMC is an author of a number of references cited in this monograph.

Consultant Maxillofacial and Craniofacial Surgeon

University College London Hospitals

London

UK

Disclosures

TWL declares that he has no competing interests.

Peer reviewers VIEW ALL

Clinical Director

Acute Medicine

Associate Medical Director

Consultant Emergency Medicine

Guy's and St Thomas' NHS Foundation Trust

Clinical Lead and Consultant

Accident Emergency Medicine

St Thomas' Hospital

London

UK

Disclosures

AP declares that he has no competing interests.

Assistant Professor of Pediatrics

Children's Hospital Boston

Harvard Medical School

Boston

MA

Disclosures

MIN declares that he has no competing interests.

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