An evaluation of a blowout fracture of the orbit begins with a history and physical examination. A complete eye examination is necessary to look for other injuries to the eye.

Physical findings in someone with a blowout fracture of the orbit may include:

• Entrapment of the eye muscles:
• Inability to gaze upward with the eye
• Sponginess to the soft tissues overlying the cheekbone
• Subconjunctival hemorrhage (blood in the white sclera of the eye)
• Swelling around the eye
• Bruising around the eye
• Tenderness of the orbital bones

Physical findings of a severe blowout fracture of the orbit may include:

• Hyphema (blood inside the eye)

The diagnosis may be made on physical findings alone, if entrapment of the eye muscles is present. Imaging tests are necessary to evaluate the severity of the fracture.

Tests that may be used to evaluate a blowout fracture of the orbit include:

• Facial bone x-rays
• CT scan of the orbit
• MRI scan of the face and orbit