Isolated medial rectus hematoma following blunt trauma-a novel case report

Abstract

This report presents a rare case of isolated medial rectus hematoma following blunt trauma in a 16-year-old male. Typically, traumatic eye injuries lead to orbital fractures or hemorrhages, but isolated rectus muscle injury and hematoma are exceptionally uncommon. Our patient exhibited unilateral total outward gaze limitation, esotropia, and horizontal diplopia without any associated cranial or orbital fractures. Orbital CT and MRI played pivotal roles in diagnosing the isolated hematoma, which was managed conservatively with oral corticosteroids, leading to complete resolution of symptoms and radiologic findings within a month. This case underscores the importance of thorough clinical examination and careful evaluation of imaging in the differential diagnosis of posttraumatic diplopia, highlighting the diagnostic challenges and the clinical utility of orbital imaging in such rare presentations.