Purpose: Oculocardiac reflex (OCR) is a life-threatening phenomenon causing a triad of bradycardia, nausea, and syncope due to a profound vagal parasympathetic response to ocular stimulus. It a rare but known manifestation of “trapdoor” orbital floor fractures seen in paediatric patients and is classically described as a feature seen with inferior rectus muscle entrapment. Methodology: We describe an unusual case of OCR in a paediatric patient without muscle entrapment. Results: A previously healthy 12-year-old boy presented to the Emergency Department after accidentally being struck in the left eye with a golf club. He was nauseated at presentation with bradycardia and hypotension. On examination, had unrestricted extra-ocular movements of both eyes. CT imaging demonstrated a small orbital floor fracture without radiological features suspicious for entrapment. While being observed, he had multiple transient episodes of OCR and subsequently underwent emergent orbital floor exploration. Intra-operatively, it was noted that he had a small trapdoor style orbital floor fracture with entrapped periosteum and orbital fascia which was reduced, and the orbital floor reconstructed using a porous gelatin sheet. No muscle or orbital fat herniation was noted. Post-operatively his vital signs were seen to completely stabilise without further issues. Conclusion: OCR is a significant, life-threatening complication of orbital fracture. While commonly thought to be due to entrapped muscle, it may occur in absence of muscle entrapment due to trigeminal stimulation of other orbital components and should be considered in all cases of significant ocular and orbital trauma.