In what situation should a patient with a potential blowout fracture receive medical therapy instead of surgery?

In the context of a potential blowout fracture, the decision between surgical and medical management significantly depends on the presence and severity of symptoms that indicate complications from the fracture. When enophthalmos is not present, it suggests that the soft tissue and ocular structures are still adequately supported, and the eye is in its normal position relative to the surrounding orbital anatomy. This absence of enophthalmos is a key factor indicating that the fracture might not be causing significant functional impairment or aesthetic concerns.

In cases without enophthalmos, a conservative approach may be taken, focusing on medical therapy to manage any symptoms, such as pain or mild diplopia (double vision), rather than immediately resorting to surgical intervention. The rationale is that the body may be able to heal itself, and surgery might be reserved for cases with more severe complications or persistent issues. Therefore, medical therapy can be an appropriate management strategy when there are no alarming signs, allowing for observation and potentially minimizing unnecessary surgical risks.