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Updated: Jun 18, 2026
08:18
Three-Dimensional Reconstruction of Orbital Fractures
Published on: May 16, 2025
Oculocardiac reflex associated with a large orbital floor fracture
Jeffrey M Joseph1, Caroline Rosenberg, Christopher I Zoumalan
1Division of Ophthalmic Plastic and Reconstructive Surgery, Department of Ophthalmology, New York University School of Medicine, New York, NY, USA.
Ophthalmic Plastic and Reconstructive Surgery
|November 26, 2009
Summary
A large orbital floor fracture caused a rare oculocardiac reflex in a patient, leading to bradycardia. Surgical repair resolved the reflex, highlighting the importance of prompt intervention for orbital trauma.
Area of Science:
- Ophthalmology
- Trauma Surgery
- Cardiology
Background:
- Blunt orbital trauma can lead to complex injuries.
- The oculocardiac reflex is a known phenomenon, typically associated with extraocular muscle entrapment.
Observation:
- A 40-year-old male experienced bradycardia, left eye pain, and nausea after blunt left orbital trauma.
- Imaging showed a large orbital floor fracture with significant herniation of orbital contents, but no muscle entrapment.
Findings:
- Oculocardiac reflex was suspected due to the patient's symptoms and orbital injury.
- Surgical repair of the orbital floor fracture was performed within 24 hours.
- Bradycardia resolved immediately following the surgical intervention.
Implications:
- This case presents a unique instance of the oculocardiac reflex associated with a large orbital floor fracture and herniation, without muscle entrapment.
- It underscores the need to consider the oculocardiac reflex in orbital trauma, even in the absence of apparent muscle entrapment.
- Prompt surgical management is crucial for resolving symptoms and preventing potential complications.
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