Fractures of the medial orbital wall

Two cases of patients with isolated medial orbital wall fractures are described. Presenting physical findings were minimal; however, both patients were noted to have bleeding into the nasopharynx from unidentified sources. Routine radiographs failed to disclose the fractures, which were clearly shown by computed tomography. Reconstructive surgery was planned for one patient. Frequently overlooked, this injury may be the cause of delayed enopthalmos, meningitis, or blindness. The presentation, diagnosis, and management of medial orbital wall fractures are reviewed.