Barotraumatic blowout fracture of the orbit

We report a rare case of a barotraumatic blowout fracture of the orbit. A 32-year-old woman presented with sudden swelling of the right orbital region after vigorous nose blowing. Computed tomography scan revealed a blowout fracture of the medial wall of the right orbit with orbital emphysema and herniation of the orbital soft tissue. She was treated with prednisolone and an antibiotic, and did not show diplopia or visual disturbance. Three different theories have so far been proposed to explain the mechanism of blowout fractures, globe-to-wall contact theory, hydraulic theory, and bone conduction theory. The present case indicates that blowout fractures of the orbit can be induced solely by a sudden change of pressure, thereby suggesting the validity of the hydraulic theory.