The Whited-eyed Blowout Fracture

Choi MS, Joh SP, Byeon JH.

 Department
of Plastic Surgery, College of Medicine, The Catholic University of Korea,
Seoul, Korea. byeon@catholic.ac.kr
Dr. Joh's Aesthetic Clinic, Seoul, Korea.

Blow-out fractures of the orbital floor are comparatively rare in children. They have some characteristics. We have come across a group of young patients(less than 16 years of age) with little or no clinical evidence "White-eyed" of soft tissue trauma(e.g., edema, ecchymosis), diplopia with restriction of vertical gaze, lack of enophthalmos and radiologic signs of minimal bone displacement. Some investigators advocate 2-week waiting period has been found to be of little benefit in these persons and possibly harmful to their motility, so surgery within the first few days after injury as it may help to avoid permanent motility restriction in "white-eyed blowout". This paper reviews our experience of six "White-eyed blowout" patients. One of the six patients has continued mild extraocular movement restriction by 7 months. But, in one patient, symptoms resolved rapidly by 1 month after surgery. We suggest that "White-eyed blowout" can be the new categories of blowout fracture.