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There are very few indications for the urgent treatment of facial fractures, in particular orbital floor fractures. Confirmed entrapment of an extraocular muscle is a well-known indication, and ruling out entrapment is an essential part of the assessment of orbital trauma. An uncommon, yet arguably more mergency indication for orbital floor fracture repair s a dysrhythmia associated with the oculocardiac eflex (OCR). The OCR, also known as the Aschner henomenon, is a physiologic response to physical timulation of the eye or adnexa. This is a vagally mediated reflex with afferent tracts derived mainly from the ophthalmic division of the trigeminal nerve. Increased stimulation results in decreased activity of the sinoatrial node. In addition to bradycardia, nausea/vomiting, vertigo, syncope, gastric hypermotility, and orbital pain are classic findings. The OCR is uite commonly elicited and has been well docuented during ocular surgery, in particular strabisus surgery, in the pediatric population. Heart block, junctional rhythms, asystole, and, rarely, death have also been described.