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Possible broken eye socket or sinus cavity?
AnonMcAnon posted:
I was punched very hard in the eye two days ago. I was not fighting nor was I expecting to be punched, so the blow was full force and square in the eyeball. Immediately following the unimaginable pain, I realized that the eyeball was sunken into my head to the point that I could not look down, up, or to the sides without my vision basically bugging out. About an hour later, I noticed that my nose started bleeding. I was punched once in the eye, not in the nose. When I went to blow my nose, the area under my eye immediately swelled up like a balloon and it hurt incredibly.

I tried to go to the emergency room and that just didn't work out. The local hospital is quite incompetent and I've never been able to get anyone to take anything seriously there. They are a huge malpractice suit away from being shut down. When I was in the ER, I was next to a man who was complaining about severe chest pain and not being able to feel his right arm. He wasn't seen either. So, I ended up just having to leave because it wasn't going anywhere and after an hour of sitting next to people who were either bleeding severely or unconscious not being seen, I figured that I was better off going to a doctor who would actually respond to my medical needs. I actually have very good health insurance and the means to pay for a medical bill. I just need a qualified doctor to actually look at me.

When I left the hospital, I started to feel pain in the back of my head and severe pain in my eye whenever it moved. I managed to shimmy the eyeball closer to its original position to ease some of the pain and to restore most of my vision in it. My eye is still quite swollen and just tonight, 2 days following the trauma, I started spitting up dark colored blood. Before that, I had felt like there was blood in my head or bleeding somewhere in my head. Now, I know I can't go to my local hospital because I had tried and failed before, so I'm planning on calling a doctor tomorrow, but I'm not entirely sure what to tell them. I want to get an idea of what might be the problem to help the doctors I contact tomorrow get a sense of whether or not they will be able to help me without me going to the hospital. Worst case scenario, I will just request to go to a hospital further away from where I live that I've been admitted to and had a better experience with, but I'd like to avoid the hospital if possible.

So, what I'm experiencing now:
  • At the very top of the inside of my nose, next to where the black eye is, I'm feeling throbbing and pain
  • Whenever I touch around my eye, the inside of my nose starts to hurt.
  • Whenever I blow my nose or touch my nose, my eye starts to hurt.
  • If I move my eye, it hurts like crazy.
  • A deep red and purple bruise is just now beginning to form under the skin around my eye, 2 days following the trauma.
  • My eyebrow has just started to hurt.
  • I'm having a lot of pain and pressure in my head and neck.
  • My jawbone is also sore and painful.
  • The area around my eye does not feel fractured or broken, but it is painful and tender to the touch.
  • I'm feeling more tired than usual, though this might not be because of the injury.
  • Occasionally spitting dark red blood.
Does anyone have any ideas of what might be wrong and what I need to tell the doctor's office on the phone for them to know if they can see me in the office? I don't have any idea of what tests they might need to do, so if anyone has any ideas, if they could please share with me.
Caprice_WebMD_Staff responded:
Hi AnonMcAnon,

It's now quite a few hours later and I hope you have since called your doctor's office and been seen. If not, telling them what you've told us here would be a very good idea. I'm sure Dr. Kozarsky will be responding as soon as he gets a chance but, in the meantime and if you haven't already, please seek direct medical attention.

Let us know how it goes for you.
Alan M Kozarsky, MD responded:
I am sorry about your injury as well as the level of care offered by your local hospital.

Your consideration of a "broken eye socket" is correct. A substantial blunt injury to the eye can break some of the thin bones that form the eye socket. This is typically an "orbital floor fracture" that will open the barrier between the eye socket and the nasal sinuses as well as possibly trap the muscles that move the eye. The eye will appear sunken as some of the eye socket contents will prolapse into the nasal sinus.

Such an injury rarely requires admission to a hospital. Your care will usually require an oculoplastic ophthalmologist ( , "Find an Eye M.D.", and search under "plastics/reconstructive") and MRI or CT imaging of the eye socket and adjacent areas. If an eye socket fracture is found, if the eye has sunken into the socket, if the eye muscles are trapped in the fracture, you will need a surgical procedure to fix the problem.

Don't forget, the most important structure in the eye socket is the eye and you need a full dilated eye exam to search for any damage to the eye itself.

I will echo the previous response that you need to find appropriate medical care promptly.

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