What is a Blowout Fracture?

A blowout fracture is a common cranial injury in which the floor of the eye socket is cracked or shattered. Most of the orbital cavity is comprised of very strong, resistant bone, though the floor is relatively thin and brittle. The force from a direct blow to the eye resonates through the walls of the orbital cavity and puts excessive pressure on the floor, thereby blowing it out. Fractures of this type are most commonly seen in patients who have been punched in the face, hit with a high-velocity sports ball, or suffered an impact from a motor vehicle accident. Most blowout fractures heal on their own without extensive medical intervention, though a badly damaged eye socket may need to be surgically repaired.

It is unlikely for a blowout fracture to be caused by direct impact to the orbital floor because the bones are relatively well protected within the face. Usually, a blow to the top or immediate front of the eye is responsible, as energy from the impact is routed downward through the orbital rims. Depending on the size of the object and the force at which it hits the face, an individual may experience additional fractures in the upper eye socket or nasal cavity.

Most serious eye injuries result in immediate pain and swelling. In the case of a blowout fracture, an individual is likely to experience double vision, especially when looking upward or downward. The cheeks may feel numb if swelling from the blowout fracture puts pressure on cranial nerves. Severe headaches, light sensitivity, nausea, and vomiting are also common. A person who experiences such symptoms following an eye injury should visit the emergency room to receive a proper diagnosis and learn about treatment options.

In the emergency room, a doctor can evaluate the physical appearance of the injury and order diagnostic imaging tests. A radiologist uses x-rays and computerized tomography (CT) scans to determine the location and extent of the blowout fracture. Patients who have non-serious fractures are usually given pain medication and instructed about home-care remedies, such as icing the affected area and limiting intense physical activity. Patients are generally scheduled for several checkups during their recovery to make sure bones are healing correctly.

An individual who has a severe fracture might need surgery. A skilled surgeon can make an incision underneath or to the side of the eye, remove stray shards of bone, and repair the orbital floor by fusing or grafting bone together. Following surgery, a patient usually needs to avoid physical activity for about one month to give the socket time to heal. Most people are able to experience full recoveries following blowout fractures within two to three months.