Ocular trauma: white-eyed blowout fracture: practice question

A Ophthalmology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Ophthalmology · Ocular trauma: white-eyed blowout fracture

Sample item

A 10-year-old struck by a cricket ball has little bruising and a white eye, but severe pain, vomiting, bradycardia and limited upgaze. CT shows a trapdoor floor fracture. What is the management?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Urgent surgical release of the entrapped tissue

A trapdoor fracture in children can trap muscle, causing the oculocardiac reflex with nausea and bradycardia and ischaemia. Urgent release within a day or two gives the best outcome. Delay risks permanent muscle damage.

Option by option

  • A. Oral steroids and review

    Steroids do not free entrapped tissue.

  • B. Nasal decongestants

    Decongestants do not address the fracture.

  • C. Urgent surgical release of the entrapped tissue (correct)

    Correct. Urgent release limits ischaemic damage to the muscle.

  • D. Observation for two weeks

    Waiting for two weeks risks permanent fibrosis and diplopia.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Ophthalmology question

What is the answer to this Ophthalmology question?

The best answer is C, Urgent surgical release of the entrapped tissue. A trapdoor fracture in children can trap muscle, causing the oculocardiac reflex with nausea and bradycardia and ischaemia.

Why is "Oral steroids and review" not the answer?

Steroids do not free entrapped tissue.

Why is "Nasal decongestants" not the answer?

Decongestants do not address the fracture.

Why is "Observation for two weeks" not the answer?

Waiting for two weeks risks permanent fibrosis and diplopia.

What concept does this question test?

It tests Ocular trauma: white-eyed blowout fracture in Ophthalmology. Urgent release within a day or two gives the best outcome. Delay risks permanent muscle damage.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Ocular trauma: white-eyed blowout fracture?

Group the red eye by what to examine and what the pupil does. Then use the flashcards and the other Ophthalmology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.