The Ophthalmology Unit, Universiti Malaysia Sarawak (UNIMAS), Kuching, Sarawak.
The Ophthalmology Department, SarawakGeneralHospital,
Kuching, Sarawak, East Malaysia.
Photo by Professor Chua
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.