DOI: https://doi.org/10.36347/sjmcr.2026.v14i03.030

Pages: 448-451

Orbital trapdoor fractures are a distinct subtype of blowout fractures that occur primarily in children, owing to their flexible bone structure, which predisposes them to soft tissue entrapment and symptoms such as diplopia. Often referred to as “white-eyed blowout” fractures due to the absence of prominent external signs, these injuries require meticulous clinical assessment and radiological evaluation. We report the case of a 13-year-old boy who presented with diplopia, photophobia and restricted upward gaze following blunt trauma to the left eye. Despite the absence of clinical external symptoms, CT imaging demonstrated inferior rectus muscle entrapment, evident by the tear-drop sign. The patient underwent emergency surgery within 2 hours, during which the entrapped muscle was released and a Vicryl mesh was placed to prevent re-entrapment. Postoperative management included anti-inflammatory therapy, and follow-up revealed marked improvement in ocular motility and complete resolution of diplopia. This case highlights the importance of early recognition, high-resolution CT imaging, and prompt surgical intervention in the treatment of pediatric orbital trapdoor fractures to avoid long-term functional deficits.