During a physical examination for periorbital ecchymosis, which finding suggests an orbital blowout fracture?

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The presence of proptosis during a physical examination suggests an orbital blowout fracture because this finding indicates potential involvement of the orbital contents and possible displacement of the eye. An orbital blowout fracture typically occurs when significant force is applied, leading to a fracture of the orbital floor. This fracture can allow for the contents of the orbit, including the globe (the eyeball), to herniate or displace due to pressure changes, which manifests as proptosis.

In addition to proptosis, other findings associated with an orbital blowout fracture could include decreased sensation in the facial region, diplopia (especially when looking up), or blood in the nasal cavity (epistaxis), but proptosis is particularly notable as it points towards structural changes within the orbit that directly affect the eye's position.

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