Which of the following is an indication for repair of an orbital floor fracture?

Repair of an orbital floor fracture is indicated primarily when there is diplopia, especially when it occurs in the primary position or during specific activities such as reading. This is because diplopia suggests that the muscles controlling eye movement may be affected by the fracture, leading to misalignment of the eyes. When the floor of the orbit is compromised, it can entrap muscles or soft tissues, causing this misalignment and resulting in double vision. Repairing the fracture can relieve the pressure on these structures and restore proper ocular alignment, thereby alleviating the diplopia.

The other options do not directly relate to the mechanical implications of an orbital floor fracture. For instance, decreased vision in low light conditions can occur for numerous reasons, including retinal issues or other ocular pathologies, but it is not a direct consequence of an orbital floor fracture that would necessitate surgical intervention. Similarly, the presence of a corneal abrasion or excessive tearing may indicate other ocular problems that are not specifically tied to an orbital fracture, and addressing those issues may not require surgical repair of the fracture itself.