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White-eyed blowout fractures with extraocular muscle (EOM) entrapment necessitate emergency surgical intervention. However, even after surgery, diplopia or EOM motion limitations may persist due to the incomplete reduction of soft tissue herniation caused by inadequate dissection or unresolved muscle strangulation. In this report, we present a case of postoperative EOM movement limitation in a 5-year-old girl who experienced recurrent restriction in the upward gaze of her right eye 14 days after surgery.

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Case report on combined approach for delayed orbital floor repair.

Natl J Maxillofac Surg

April 2023

Department of Oral and Maxillofacial Surgery, KMCT Dental College, Kozhikode, Kerala, India.

"White-eyed blowout" fractures in pediatric patients can be presented with fewer clinical symptoms; therefore, immediate diagnosis and surgery is essential. In cases where early surgery was performed, rapid recovery and better postoperative outcomes were noted regardless of the configuration of fracture. In pediatric patients, due to changes in the orbital volume, autograft is recommended.

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Orbital floor fracture is the most common type of orbit-related injury seen in pediatric age groups. It is also called a  blowout fracture when the usual signs of orbital fracture-periorbital edema, ecchymosis, and subconjunctival hemorrhage are absent. Several materials are used for orbital defect reconstruction.

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White-eyed orbital blowout fractures in the pediatric population can present with acute onset diplopia, ophthalmalgia, and abnormal duction. These findings are attributed to the tendency of younger bone to break and reapproximate owing to greater elasticity. This phenomenon, commonly referred to as the greenstick fracture, increases the risk of entrapment of surrounding soft tissue structures in orbital floor fractures.

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White-eyed blowout fracture, child in danger: A case report.

Malays Fam Physician

March 2022

M.D (USM), M.Surg (Ophthal)(UKM) FADUSM, Department of Ophthalmology and Visual Science, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kelantan, Malaysia, Email:

A white-eyed blowout fracture is an orbital floor fracture associated with restriction of ocular motility (suggestive of orbital content entrapment) but with minimal or absence of signs of soft tissue trauma. It can lead to significant patient morbidity. This case involved an 8-year-old boy with a white-eyed blowout fracture following facial trauma.

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