A Case of Pediatric Orbital Fracture with Successful Recovery After Elective Surgery

Akaoka Sakura, Shinmei Yasuhiro, Osawa Masayuki, Hasegawa Ayaka, Suzuki Kayo, Shinkai Akihiro, Suimon Yuka, Tagawa Yoshiaki, Ishida Susumu

doi:10.11476/shinkeiganka.38.25

<p>　We report a case of white-eyed blowout fracture in a 10-year-old boy whose right eye was injured by a ball during a baseball game. He presented to our emergency department with nausea and impaired consciousness and was referred to our ophthalmology clinic the following day. His best-corrected visual acuity was 1.2 in both eyes despite right-sided commotio retinae observed on fundoscopy. We suspected a closed fracture of the inner wall of the right orbit based on orbital computed tomography. However, he did not experience double vision; therefore, we decided to observe his progress. He developed double vision and visited a local physician, 3 days later. He was re-referred to our hospital with restricted right eye adduction. Orbital magnetic resonance imaging revealed incarceration of soft tissue at the fracture site. We consulted plastic surgeons for surgical indications. The orbital wall fracture was repaired a month later. Intraoperatively, we observed that 3-5 mm of the orbital periosteum was trapped within a linear fracture of the inner orbital wall, and this tissue was immediately released. The patient’ eye movements recovered and double vision completely disappeared postoperatively. We concluded that incarceration of tissue surrounding the right medial rectus at the fracture site was mild in this patient; therefore, the patient could be successfully treated and showed favorable prognosis following elective surgery.</p>

A Case of Pediatric Orbital Fracture with Successful Recovery After Elective Surgery

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