BMJ Case Reports 2018; doi:10.1136/bcr-2018-224633
  • Unusual presentation of more common disease/injury

Orbital blowout fracture from nose blowing

  1. Daniel Bell
  1. Department of Radiology, North Middlesex University Hospital NHS Trust, London, UK
  1. Correspondence to Dr Sam Myers, sam.myers1{at}
  • Accepted 12 June 2018
  • Published 28 June 2018


Orbital blowout fractures are nearly always caused by acute trauma. Non-traumatic cases of orbital blowout fractures have only been rarely described. In this case study, we discuss an orbital blowout fracture directly caused by nose blowing. The patient developed unilateral eye swelling and orbital emphysema. It is important for the clinician to investigate all suspected orbital blowout fractures with imaging and full ophthalmological examination regardless of a trauma history. Most cases of orbital emphysema resolve spontaneously, however one must always exclude compression of the central retinal artery. This may present as acute loss of vision and/or ophthalmoplegia.


  • Contributors SM is the corresponding author: contributed to conception, drafting and finalising of report. DB contributed to conception, drafting and finalising of report.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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