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Broken Orbital Bone and is Sinking, What Should I Do? (photo)

asked 4 months ago by Jimmy81
Latest answer by Julio Garcia, MD
Question viewed 598 times
Tags: damage, orbital wall

I got punched in the face a lot when I had a drinking problem (sober now) but I'm afraid my eyeball is sinking. I know for sure I broke the orbital floor of my eye at least once (the second time I was in mexico two years and couldn't get a professional opinion). I'd like to know if my eye will keep sinking. Please see the photo and let me know if you think this problem can be fixed. Thank you.

17 answers to Broken Orbital Bone and is Sinking, What Should I Do? (photo)

Sinking eye

Although it is obvious that there is asymmetry between your two eyes, it is difficult to tell whether you have a vertical (up and down) or a posterior (backwards) displacement of your left eye. A proper exam will help determine that. Also a CT scan of your face (specifically ordered to examine your facial bones) will also be important to find out where the volume of your orbit is being displaced. Then techniques aimed to restore the bony orbit, in addition to possibly... more

Tito Vasquez, MD
Southport Plastic Surgeon

Enophthalmos

It appears you have enophthalmos on the left side. This is likely stable, meaning it already sunken that not sinking any more, or maybe worsening if there additional sinus issues. You should consult an oculopalstic surgeon, who with the help of CT scan can better determine possible solutions.

Mehryar (Ray) Taban, MD, FACS
Los Angeles Oculoplastic Surgeon

Correction of Sunken Eye (enophthalmos)

The eye socket is engineered to rapidly expand in response to injury allowing the eye ball to be easily be pushed in to avoid damage. This happens with many blows to the cheek or eye regions because the inner wall and floor of the orbit are very thin (egg shell thin) and are essentially a biological crumple zone. They give way to save the eye ball. Delayed correction is based on a CT or MRI imaging coming the right and left orbits and which areas need to be filled in. This will... more

Peter A. Aldea, MD
Memphis Plastic Surgeon

Broken Orbital Bone and is Sinking, What Should I Do? (photo)

Actually you have two problems. One is that the eye is already sunken. The other is that the eye will probably continue to sink. You really need to see an Oculoplastic surgeon because even if you would tolerate the way the eye looks now, it is likely to get worse and then you won't tolerate it. Exactly what can be done will depend on a lot of factors. Do you have a CT scan?

Sam Goldberger, MD
Beverly Hills Oculoplastic Surgeon

www.neweyelids.com

Sinking eye after injury

Hello Jimmy, This does occur and I can see a little of what's called enophthalmos and hypoglobus in you. The steps are these: 1. Consult with a facial plastics or oculoplastic surgeon. 2. Get a CT scan of your orbits. This will tell your surgeon how much volume loss has occurred in the floor and even give you an opportunity to create a custom implant in some cases. You options are synthetic implants (great option and the... more

Chase Lay, MD
Bay Area Facial Plastic Surgeon

www.chaselaymd.com

Eye sinking due to broken orbital bone

Yes, your eye seems to be sinking in. The problem can be fixed with with a late repair of the orbital floor with a thin floor implant. Since you are not experiencing double vision, there is no problem with a late repair. Consult with an ophthalmic plastic surgeon but there is no big hurry. You should only hurry if the trauma happened last week.

Peter T. Truong, MD
Fresno Oculoplastic Surgeon

www.facialsurgerydr.com

Eye sinking after trauma

As you mentioned you have an old orbital floor fracture. With large fractures you can get retrusion of the eye. The retrusion may be improved depending on the anatomy of your injury. Another important issue is your vision in all visual fields. I would recommend seeing a plastic surgeon in your area experienced with craniofacial surgery. It would be very unusual for a change to be occurring after over two years from the injury.

Jay M. Pensler, MD
Chicago Plastic Surgeon

Orbital fracture

Orbital fractures can lead to enophhtalmos because in many cases the orbital cavity is expanded and the eye sinks back in. IDeally you like to fix this during the first few weeks after injury. The problem with delayed treatment is that the muscles shorten as well and it becomes very difficult to lift the eye and bring it forward once it has contracted down. Diplopia or double vision may get better, be worse, or not change after surgery.

Steven Wallach, MD
Manhattan Plastic Surgeon

Eye Problems After Fracture

You have what is called Enophthalmos, where the eye falls back into the orbit as a result of trauma - most commonly an orbital floor fracture. There are surgeries to correct this by adding to the orbit and reducing the volume so the eye matched the other side. You would want to see a surgeon who specializes in craniofacial trauma. Best of luck, Vincent Marin, MD San Diego Plastic Surgeon

Vincent P. Marin, MD
San Diego Plastic Surgeon

Orbital Fracture Repair

It does appear from your photograph that your eye is sinking. You should seek a consultation from an Ophthalmic Plastic Surgeon or Facial Plastic Surgeon. They will need to order a CT scan to determine the extent of the orbital fracture. An orbital floor fracture can be repaired by placing an implant that prevents the eyeball from sinking. In most cases, this can be done through the inside of the eyelid (a transconjunctival approach) without making a skin incision.

David Schlessinger, MD
New York Oculoplastic Surgeon

schlessingereyeandface.com

To answer this question you need to see an oculoplastic surgeon.

Jimmy You left orbit is consistent with a prior orbital facture. To confirm this you should have a through orbital evaluation by an oculoplastic surgery and a CT scan of the orbits. This will confirm the degree of change in the orbit and based on this the surgeon will be able to discuss with you a range of options. You should know that later repairs are often much less successful than immediate repairs. Does this mean you shouldn't bother with a consultation.... more

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon

What to do after an orbital fracture

If you had a trauma that caused a fracture of the bones around the eye, it is possible that the eye is sinking backward. In most cases this can be improved with surgery. The first step is to see a surgeon who has experience with orbital trauma such as an oculoplastic surgeon. Your doctor will want to get a CT to see what is happening with the bones around the eye. Surgery can be more difficult when the problem has been there for a while but it is still possible most of the... more

Brett S. Kotlus, MD
Rochester Oculoplastic Surgeon

Broken Orbital Bone and is Sinking, What Should I Do?

If the last injury was that long ago, most likely the floor of the orbit has healed in its position and further movement will occur. As to fixing it, a surgeon could go in there and place a small flat floor implant to raise the contents of the eye socket up to try to achieve better symmetry.

Julio Garcia, MD
Las Vegas Plastic Surgeon

lvcosmeticsurgery.com

Unlikely to continue sinking.

It is unlikely that things will change this far out from the injury. A CT scan of the orbits [maxillofacial] would help elucidate the problem.

A.J. Amadi, MD
Seattle Oculoplastic Surgeon

Fracture around the eye

Your posted photo shows a smaller left eye than right eye and retrusion or sinking in of the majority of the left middle third of the face. I suspect that there is more going on here than just a fracture of the bone floor under the eyeball as that would not also result in cheek bone retrusion. You need a CT scan in order to assess exactly what is going on before you can undergo any treatment. Unfortunately when these injuries are old the soft tissue around the bones shrinks back and... more

Aaron Stone, MD
Los Angeles Plastic Surgeon

Sinking following orbital bone fracture

Jimmy, The problem that you are describing is know as enophthalmos. This refers to the "sinking" appearance of the eye following a fracture of the orbital floor (the bone beneath and around the eyeball). If your fracture is old, it is unlikely that it will progress further; however, to correct the problem you will probably need to see a craniofacial surgeon (a plastic surgeon who specializes in surgery of the facial skeleton). He or she will likely... more

Anureet K. Bajaj, MD
Oklahoma City Plastic Surgeon

Broken Orbital Bone and is Sinking, What Should I Do?

Hurry to see an ENT, facial plastic or plastic surgeon in your area to rule out an orbital fracture. Time is is of the seesence with these types on injuries.