Orbital trauma most commonly occurs with high-speed impact injuries such as motor vehicle accidents and violent altercations. Fractures of the orbital floor are the most common fracture seen in these cases, and entrapment of the inferior rectus muscle is seen in many instances. Patients typically present with a tremendous amount of swelling and bruising around the eye, and an inability to look upwards. The exception to this occurs in children who often present with no external visible signs of trauma. They may complain of double vision when looking straight ahead and/or in an upward gaze.
Prognosis is dependent on how quickly the diagnosis is made. If the muscle is entrapped, the blood supply is also reduced, and a longer time interval to surgery may carry a poorer prognosis for full recovery.
A CT scan is often performed to confirm the diagnosis and visualize the extent of the fracture. Surgery is needed if the muscle is obviously entrapped or if a short period of waiting does not seem to improve the double vision.
Appropriate eye protection in contact sports may help prevent some cases of orbital fractures.