Neuro-ophthalmology: Case thirteen

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Figure 1

Figure 2

This 23 year-old man sustained a left black eye (figure 1) during a rugby match. There was no radiological evidence of orbital fracture. However, he developed increased swelling of his left eye whenever he blew his nose (figure 2).

a. What is the diagnosis?

b. What is responsible for this appearance?

c. How would you manage this patient?