{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:44:30Z","timestamp":1787010270172,"version":"build-2736575974"},"reference-count":9,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Pediatr Emer Care"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Blowout fractures of the floor of the orbit can serve as a \u201ctrap door\u201d for extraocular muscles. Presentation of inferior orbital muscle entrapment classically involves an upward gaze restriction. Diplopia and exophthalmos can also be present. Rarely, orbital fractures can result in an oculocardiac reflex, which is a triad of bradycardia, syncope, and nausea. The purpose of this study was to describe a patient who had orbital floor fracture with symptoms highly suggestive for oculocardiac reflex after a traumatic injury. Although entrapment of extraocular muscles does require early intervention to prevent ischemia and tissue necrosis, the presence of oculocardiac reflex warrants emergent evaluation and management by an ophthalmologist due to the risk of developing arrhythmias. Frequently, there may be none or very subtle clinical findings present, and abnormal motility may be the only apparent clinical sign, which can be difficult to assess in very young and uncooperative children; therefore, a high index of suspicion must be maintained for early identification and management as well as a reduction of complications.<\/jats:p>","DOI":"10.1097\/pec.0000000000001884","type":"journal-article","created":{"date-parts":[[2019,8,6]],"date-time":"2019-08-06T08:11:15Z","timestamp":1565079075000},"page":"e1731-e1732","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":8,"title":["Oculocardiac Reflex: An Underrecognized But Important Association With Orbital Trap Door Fractures"],"prefix":"10.1097","volume":"37","author":[{"given":"Noormah","family":"Mehmood","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Hasan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2019,8,6]]},"reference":[{"key":"bib1-20250504","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1159\/000238932","article-title":"An analysis of 733 surgically treated blowout fractures","volume":"224","year":"2010","journal-title":"Ophthalmologica"},{"key":"bib2-20250504","doi-asserted-by":"crossref","first-page":"009","DOI":"10.1055\/s-0032-1332213","article-title":"Pediatric orbital fractures","volume":"6","year":"2013","journal-title":"Craniomaxillofac Trauma Reconstr"},{"key":"bib3-20250504","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/j.sjopt.2012.05.008","article-title":"Orbital trapdoor fractures","volume":"26","year":"2012","journal-title":"Saudi J Ophthalmol"},{"key":"bib4-20250504","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/j.jaapos.2011.02.005","article-title":"Pediatric orbital floor fractures","volume":"15","year":"2011","journal-title":"J AAPOS"},{"key":"bib5-20250504","doi-asserted-by":"crossref","first-page":"e477","DOI":"10.1097\/MD.0000000000000477","article-title":"Diplopia of pediatric orbital blowout fractures: a retrospective study of 83 patients classified by age groups","volume":"94","year":"2015","journal-title":"Medicine (Baltimore)"},{"key":"bib6-20250504","first-page":"955","article-title":"Oculocardiac reflex caused by orbital floor trapdoor fracture: an indication for urgent repair","volume":"116","year":"1998","journal-title":"Arch Ophthalmol"},{"key":"bib7-20250504","first-page":"22","article-title":"Chronic trigemino-cardiac reflex: an underestimated truth","volume":"8","year":"2017","journal-title":"Front Neurol"},{"key":"bib8-20250504","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/S0194-59980300487-X","article-title":"Pediatric orbital floor fractures: nausea\/vomiting as signs of entrapment","volume":"129","year":"2003","journal-title":"Otolaryngol Head Neck Surg"},{"key":"bib9-20250504","doi-asserted-by":"crossref","first-page":"1310","DOI":"10.1016\/j.joms.2009.12.037","article-title":"Surgical management of orbital trapdoor fracture in a pediatric population","volume":"68","year":"2010","journal-title":"J Oral Maxillofac Surg"}],"container-title":["Pediatric Emergency Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/PEC.0000000000001884","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,4]],"date-time":"2025-05-04T16:04:28Z","timestamp":1746374668000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/PEC.0000000000001884"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,8,6]]},"references-count":9,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.1097\/pec.0000000000001884","relation":{},"ISSN":["1535-1815","0749-5161"],"issn-type":[{"value":"1535-1815","type":"electronic"},{"value":"0749-5161","type":"print"}],"subject":[],"published":{"date-parts":[[2019,8,6]]}}}