Unfolding tale of post-traumatic globe luxation into the ethmoid sinus: an unusual encounter in ophthalmology

Traumatic displacement of the eyeball into the paranasal sinuses is an exceptionally uncommon sequelae following head injury, particularly when the orbit is the site of major impact. We present a case of a ruptured globe dislocation into the ethmoid sinus with extensive bilateral orbital fractures in a male in his early 20s, following a high-velocity motor vehicle (two-wheeler) road traffic accident 3 weeks ago. He also sustained a right optic canal fracture with encephalocele, which led to traumatic optic neuropathy. The case was managed through a multidisciplinary staged surgical approach. The delayed presentation led to globe devitalisation, necessitating enucleation followed by orbital wall reconstruction and prosthetic rehabilitation. Subsequently, the encephalocele was surgically repaired. This case differs from earlier reports because it involves a unique combination of globe rupture and luxation of the left eye with encephalocele and optic canal fracture, inducing direct traumatic optic neuropathy of the right eye.