Background : The orbital fracture clinical signs are highly related to the trauma mechanism, according to the walls affected. Recognizing these signs can be a useful tool, such as palpebral ecchymosis, subconjunctival hemorrhage and palpebral haematoma.

Objectives : Establish whether there is a correlation between clinical signs found in the initial examination of a patient with orbital fractures, imaging findings and orbital fracture patterns based on biomechanical factors associated with different trauma mechanisms which are considered to be causative of these lesions.

Methods : Cross-sectional study was conducted recording all patients ( n = 34) with orbital fractures treated in the Maxillofacial Surgery Unit at Hospital Carlos Van Buren, 2011–2012. An assessment of clinical signs and orbital TC aiming different trauma mechanisms was performed to clarify and correlate signs and orbital fractures patterns.

Results : We found that patients who had palpebral ecchymosis were more prone to have a main orbital wall disrupt, caused by direct application of the force transmitted to the orbital architecture. However, when blunt trauma applied to the eye globe occurs, it is more likely to have “eye signs” such as subconjunctival hemorrhage, causing fractures of the thinner walls due to the hydraulic pressure of the eye globe.

Key words : orbital trauma and/or fracture; orbital blunt trauma; orbital walls