Blow out fracture with Oculocardiac reflex
Keywords:
Bradycardia, Blow out fracture, Oculocardiac reflexAbstract
The oculocardiac reflex is generally seen in children and usually occurs during surgery in the orbital area. In patients who have orbital fractures, it often happens in cases of open and closed orbital fractures that result in fractured orbital bones compressing the extraocular muscles. When these muscles are pinched by the bone, it may trigger the oculocardiac reflex (OCR).
The occurrence of the oculocardiac reflex due to an orbital blow out fracture is uncommon in adults. This case report discussed its occurrence in an adult patient. The patient had left ocular pain with binocular diplopia, enophthalmos, and upward eye movement, which caused nausea and vomiting, and presented with bradycardia before surgery. A CT scan confirmed a fracture of the left orbital floor. The patient's electrocardiogram (EKG) showed sinus bradycardia, necessitating urgent surgical intervention. The diagnosis and management of the orbital fracture began with assessing the damage and the fracture site using a three-dimensional CT scan. The surgical intervention aimed to reposition the bones and align the extraocular muscles and periorbital soft tissue within the eye socket to restore the volume of the orbit to its original state. After surgery, the patient could see clearly without diplopia and had a normal pulse.
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