Simulated blowout fracture of the orbit

A case of probable traumatic simulated Brown's syndrome, in which there was a false positive orbital tomogram, is presented. To our knowledge, this combination of findings has not been previously reported. The deceptive clinical signs combined with the false positive radiologic data led to the erroneous diagnosis of blowout fracture of the orbital floor and to a subsequent negative surgical exploration. Surgeons should be aware that these two infrequent findings may occur together. When there is any doubt about the diagnosis of blowout fracture of the orbital floor with muscle entrapment, conservative management may be indicated.