Involvement of lateral orbital wall
Isolated lateral orbital wall fractures are rare and only occur after isolated trauma to this anatomical structure. Much more common is a lateral orbital wall fracture together with a zygoma fracture (as shown).
Displacement of the lateral orbital wall (with or without combined zygomatic complex fracture) directly affects the intraorbital volume (ie, inwards displacement results in exophthalmos whereas outward displacement results in enophthalmos). However, such globe displacements are camouflaged by posttraumatic swelling so that the above mentioned sequelae often become apparent only after swelling has decreased, which normally takes about 2 weeks.
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Clinical examination of the lateral orbital wall area is camouflaged by the overlying soft tissues. However, this CT scan nicely shows contour differences at the lateral orbital wall area.
Severely inward displaced lateral orbital wall fractures might require emergency treatment, if intraorbital pressure (due to displacement and/or intraorbital hematoma) is compromising optic nerve function (see axial CT scan).