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

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.

Doctor Answers (17)

Correction of Sunken Eye (enophthalmos)

+3

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 require one or more incisions around the eye combined with placement of bone grafts with or without a new artificial floor of the ye socket. 

Your first step is to be seen by a Plastic surgeon and have a CT or MRI. Be aware that this may not be covered by medical insurance since it s done for cosmetic purposes. 


Memphis Plastic Surgeon
5.0 out of 5 stars 61 reviews

Sinking eye

+2

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 adding volume via bone grafts or synthetic materials, should be utilized to both provide symmetry and correct any visual disturbances.

Tito Vasquez, MD, FACS
Southport Plastic Surgeon
5.0 out of 5 stars 4 reviews

Enophthalmos

+2

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
Beverly Hills Oculoplastic Surgeon
5.0 out of 5 stars 7 reviews

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

+2

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
4.5 out of 5 stars 13 reviews

Sinking eye after injury

+2

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 most convenient) or bone from elsewhere.  I don't think you'd need bone.

3.  The surgery can be done with no external incision called a transconjunctival approach.  The implant is placed through that approach.  You'd have a small incision in the corner of your eye.

General risks are imperfect result, double vision, or an eye that is pushed up or forward a bit too much.  However, a little too much in the beginning is usually good because that will settle as the swelling goes away.

Hope that helps.

Chase Lay, MD

 

Chase Lay, MD
Bay Area Facial Plastic Surgeon
5.0 out of 5 stars 39 reviews

Eye sinking due to broken orbital bone

+2

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
5.0 out of 5 stars 7 reviews

Eye sinking after trauma

+2

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
4.5 out of 5 stars 10 reviews

Orbital fracture

+2

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
4.5 out of 5 stars 17 reviews

Eye Problems After Fracture

+2

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
5.0 out of 5 stars 26 reviews

Orbital Fracture Repair

+2

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
Long Island Oculoplastic Surgeon
4.5 out of 5 stars 9 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.