Anisocoria following reduction of bilateral orbital floor fractures.

Anisocoria following orbital floor fractures or their repair has been infrequently reported. A case is presented of transient anisocoria following repair of bilateral orbital floor blowout fracture. This was present for less than two hours and resolved spontaneously. The cause is presumed to be a brief neuropraxia to the parasympathetic postganglionic fibers that follow the inferior oblique muscle, which may be entrapped in the fracture. Review of the pathophysiology is presented.