The Ophthalmology Unit,  Universiti Malaysia Sarawak (UNIMAS), Kuching, Sarawak.

The Ophthalmology Department, Sarawak General Hospital, Kuching, Sarawak, East Malaysia.

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Posterior orbital floor fracture

Photo by Professor Chua Chung Nen

This 53 year-old woman complained of diplopia on downgaze following a road traffic accident in which she was a front seat passenger. Examination revealed some limitations on downgaze but the upgaze was normal. A CT scan showed orbital floor fracture posterior to the equator of the globe. An ENT opinion was sought for endoscopic repositioning of the orbital content. However, as the lesion was very posterior and the patient only experienced diplopia on extreme downgaze, it was thought prudent to observe rather than operate and the patient agreed with the decision.

 

Slight limitation of the left globe on downgaze. Upgaze was normal.

 

Posterior orbital floor fracture.

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