A, Teenaged patient following blunt trauma to the eye and orbit. Attempted gaze up and left. The left eye is unable to elevate to midline. (Note: The pupillary dilation is pharmacologic). B, Coronal CT scan of the orbit showing a small orbital floor fracture and inferior rectus muscle prolapsing into the maxillary sinus (arrow). C, Intraoperative view of a similar case showing an orbital floor defect (arrow) enlarged surgically to release and extract inferior rectus muscle. D, Two months postoperatively, the patient demonstrates resolution of upgaze limitation.