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Noticed upper eyelid after a fall. Could this be fracture in the orbital lobe?

Apr 2013
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General Surgeon
Practicing since : 2009
Answered : 3037 Questions
My 14 month old fell at daycare today. He hit the left corner of his eye. Where he hit his eye it's red and looks like a minor cut. His entire upper eyelid is swollen. There is no redness in his eye but I'm concerned that he might have possibly fractured his orbital lobe. Daycare said it bruised immediately and when I picked him up it was swollen but is more swollen after 2 hrs. There is no deformity in his face (indentions or the like). Should I just watch it or should I take him to the ER for an xray to determine if there is a fracture? Daycare gave me an incident report where they say there is no medical intervention required but they're a daycare and I'm sure their medical expertise is limited.
Posted Thu, 12 Dec 2013 in General Health
Answered by Dr. Ivan R. Rommstein 54 minutes later
Brief Answer: Hi and welcome to XXXXXXX Detailed Answer: Thanks for the query. First,for orbital wall fracture,high energy trauma is necessary and it doesnt happen easily so I doubt that there is a fracture. Even if there is a fracture,most of them are treated conservatively. The only serious thing which can happen is if can be if heamtoma closes his eye and then hematoma evacuation by ophtalmologist may be required. Also,check if his eyes on affected side can move normally; if there are crossed eyes it may indicate paralysis of ocular muscles. But this is rarely seen in such traumas. I think you should just wait at this point and see will swelling progress. I am sure it will subside in 2-3 days and I dont think that further evaluation or management is necessary. Wish you good health. Feel free to ask. Regards
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