Oculocardiac reflex in a medial orbital wall fracture without clinically evident entrapment

Lakshman Swam, Laura T. Phan, Zakeya M. Sadah, Timothy J. McCulley, Ronald E. Warwar

Research output: Contribution to journalArticlepeer-review


In this report, we describe a patient with a medial wall orbital fracture, who presented with vasovagal-like symptoms secondary to an oculocardiac reflex. This case is unusual because the patient had no other clinical evidence of muscle entrapment. A 15-year-old male presented with daily 5-10 min episodes of dizziness, light headedness, and nausea consistent with a vasovagal reaction. On examination, the patient had full extra ocular motility and was orthotropic in all fields of gaze. On computed tomography a comminuted medial orbital wall fracture was identified. The adjacent medial rectus muscle was in normal position, but was "rounded" relative to the contralateral side. The patient underwent fracture repair with immediate resolution of all symptoms. Symptoms related to a vasovagal response may occur with orbital fractures despite normal extra ocular motility. Presumably this relates to tension or pulling on an extra ocular muscle, which is not to a degree that alteration in function is appreciable clinically.

Original languageEnglish (US)
Pages (from-to)268-270
Number of pages3
JournalMiddle East African Journal of Ophthalmology
Issue number3
StatePublished - 2013


  • Fracture
  • Muscle Entrapment
  • Oculocardiac Reflex
  • Orbit Trauma
  • Orthostatic Hypotension
  • Vasovagal

ASJC Scopus subject areas

  • Ophthalmology


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