Abstract
A 16-year-old boy, while playing basketball, was hit by an elbow in the right orbital area. He sustained diplopia, nausea and vomiting with minimal soft tissue signs of trauma and visited our clinic on the same day. Marked motility restriction was present in up-and-down gaze. Computed tomography scanning revealed a small crack on the orbital floor. There was no improvement at 7 days, and at 14 days after the accident he underwent surgery via the transmaxillary approach. Intraoperatively, the author found that the inferior rectus muscle was severely herniated and was ischemic and edematous. Although these findings suggested a poor prognosis, the diplopia disappeared 5 months after the surgery. Jordan et al. described the "white-eyed blowout" fracture in 1998. This is an important subgroup supporting our clinical knowledge that young patients with marked diplopia without severe soft tissue signs of trauma sometimes require urgent surgery. Operative findings of the severely herniated extraocular muscle in the white-eyed blowout fracture are so significant that all related physicians should be well educated and never miss the timing of surgical intervention.
