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Concealed globe dislocation without enophthalmos following a low-velocity impact
1Department of Ophthalmology, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan; School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.
The American Journal of Emergency Medicine
|August 2, 2025
Summary
A rare traumatic globe dislocation into the maxillary sinus was initially missed due to facial injuries. Urgent imaging is crucial for severe facial trauma to detect hidden ocular injuries.
Area of Science:
- Ophthalmology
- Trauma Surgery
- Radiology
Background:
- Traumatic globe dislocation is an extremely rare and severe ocular injury.
- Facial trauma can present with multiple injuries, potentially masking ocular emergencies.
Observation:
- A 61-year-old woman sustained a traumatic globe dislocation after a fall onto a motorcycle handlebar.
- Initial assessment overlooked the globe dislocation due to distracting facial injuries and swelling.
- A computed tomography (CT) scan revealed the globe had dislocated into the maxillary sinus.
Findings:
- Surgical repositioning of the globe was technically successful.
- The patient experienced permanent vision loss due to optic nerve damage.
- Delayed diagnosis contributed to the irreversible visual outcome.
Implications:
- This case underscores the importance of high-vigilance in evaluating severe facial trauma.
- Urgent and comprehensive imaging, including CT scans, is essential to identify concealed ocular injuries.
- Prompt diagnosis and management are critical to potentially mitigate severe visual consequences in similar cases.
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