Orbital Floor Fracture

A blow to the eye or cheek can break the thin bone beneath the eye (the orbital floor) or the inner wall of the eye socket.

• Double vision, especially when looking up or down.
• Pain on moving the eye.
• Numbness of the cheek or upper lip on the injured side.
• The eye sinking back into the socket over the following days or weeks.

Any reduced vision after an injury needs a same-day eye examination. In children, a trapped eye muscle can cause pain, nausea, vomiting or a slow heart rate, and needs urgent surgery.

• An eye examination: vision, eye movements, double vision and the position of the eye.
• A thin-slice CT scan of the orbits to show the fracture.
• Checks for other injury to the eye itself.

• Many fractures do not need surgery. Double vision often settles within two to three weeks as swelling goes down.
• Avoid blowing your nose for about four to six weeks after the injury.
• Surgery is urgent when an eye muscle is trapped. Otherwise, it is usually considered after about two weeks for double vision that does not improve, or a fracture large enough to make the eye sink back.
• Repair usually places an implant along the orbital floor, through the inside of the lower eyelid.

• Swelling and bruising settle over a few weeks.
• The final result, including eye position and any remaining double vision, is judged over six to nine months.

Every operation carries some risk. Your doctor will go through the risks that apply to you before you decide.

• Double vision that continues after surgery.
• Infection, or the implant moving out of position.
• Numbness of the cheek.
• Rarely, loss of vision.