Pure Orbital Floor Blow-In Fracture: An Extremely Rare Case

Area of Science:

• Ophthalmology
• Neurosurgery
• Trauma Surgery

Background:

• Orbital floor fractures can result from head trauma.
• Blow-in fractures (BIF) are less common than blow-out fractures.
• Pure orbital floor BIFs are exceedingly rare, with limited published cases.

Observation:

• A 57-year-old male presented with left eye diplopia and pain after head trauma.
• CT scan revealed a left orbital floor fracture with a bone fragment protruding into the orbit.
• Hess charts showed significantly restricted vertical eye movement.

Findings:

• The patient was diagnosed with a pure orbital floor blow-in fracture (BIF).
• Conservative management for two weeks failed to resolve symptoms.
• Surgical intervention involved transcutaneous removal of the bone fragment using navigation and endoscopy.

Implications:

• This case highlights a rare presentation of orbital floor trauma.
• Endoscopic and navigation-assisted surgery can be effective for pure BIF.
• Successful surgical outcomes can be achieved for complex orbital floor fractures.