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Case Reports in Emergency Medicine
Volume 2013, Article ID 376564, 4 pages
http://dx.doi.org/10.1155/2013/376564
Case Report

Paediatric Orbital Fractures: The Importance of Regular Thorough Eye Assessment and Appropriate Referral

Department of Oral & Maxillofacial Surgery, Northwick Park Hospital, London HA1 3UJ, UK

Received 7 September 2013; Accepted 1 October 2013

Academic Editors: H. David, K. Imanaka, and M. T. Ventura

Copyright © 2013 Karim Kassam et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The paediatric orbital fracture should always raise alarm bells to all clinicians working in an emergency department. A delay or failure in diagnosis and appropriate referral can result in rapidly developing and profound complications. We present a boy of childhood age who sustained trauma to his eye during a bicycle injury. Acceptance of the referral was based on no eye signs; however, on examination in our unit the eye had reduction in visual acuity, no pupillary reaction, and ophthalmoplegia. CT scan suggested bone impinging on the globe and the child was rushed to theatre for removal of the bony fragment. Postoperatively no improvement was noted and a diagnosis of traumatic optic neuropathy was made. An overview of factors complicating paediatric orbital injuries, their associated “red flags”, and appropriate referral are discussed in this short paper.