Intervention within days for some orbital floor fractures: The white-eyed blowout

Management of blowout fractures involving the orbital floor has been contro versial over the past several decades. One school of thought recommends con servative treatment for 4 to 6 months while another recommends a 'wait and watch' period of 2 weeks before intervention. The authors have encountered a group of patients with such fractures, commonly children (less than 16 ye ars of age), who have sustained a blow to the periocular area, yet have mar ked motility restrictions in up and down gaze, minimal soft tissue signs of trauma, lack of enophthalmos, and very minimal evidence of floor disruptio n on radiologic exam. A 2-week waiting period has been found to be of littl e benefit in these persons and possibly harmful to their motility. We advoc ate surgery within the first few days after injury as it may help to avoid permanent motility restriction. The authors have termed this entity 'the wh ite-eyed blowout fracture.'