Enophthalmos And/or Hypoglobus After Orbital Floor Fracture? (photo)

Question

I am concerned that my eye is displaced after an orbital floor fracture. I had surgery 5+ weeks ago to repair the orbital floor and zygoma. It appears that the injured eye is lower and more posterior than the other. What are my options? If it ends up that my eye is out of position, what is the procedure to correct it? When will I be able to undergo such a procedure, given I just had surgery on the area less than 2 months ago? My left lower eyelid sags from the transconjunctival incision btw.

Mehryar (Ray) Taban, MD, FACS · Answer

Best to see an oculoplastic specialist for examination along with CT scan of your orbits. One other thing that can give illusion of the eyeballs look being displaced is if the eyelids are asymmetric. For instance, your left lower eyelid is lower than the right side, which may require eyelid surgery instead of orbit surgery.

Kenneth Hughes, MD · Answer

The correction in these cases is never perfect.  In the absence of double vision, you should wait for several months for resolution of swelling.  The lid should be massaged and nighttime taping instituted as conservative measures for eyelid malposition.

Stephen Prendiville, MD · Answer

I agree with previous posters that there is evidence of ectropion which will likely require surgical correction. Although it is best to wait and allow inflammation to subside, earlier intervention is sometimes necessary because of dry eye symptoms.  Unfortunately, even in best case scenarios with an orbital blow out fracture, some degree of orbital volume loss and enophthalmos can occur.  This can be countered with placement of an orbital floor implant.  However, it would be optimal to wait 6 months to a year prior to proceeding.  Additionally, this type of procedure is probably best performed by an ASOPRS trained Occuloplastic Surgeon.

Jonathan Kulbersh, MD · Answer

I agree with the other post.  You do have ectropion and enopthalmos.  Depending on the severity of the two issues, you may require surgery and you might want to consider fillers to the cheek area.  Fillers in this area can improve the symmetry of your face and push up your lower lid.  

	 

	I hope this helps.

Barry L. Eppley, MD, DMD · Answer

I think you have an isolated lower lid retraction but not a globe displacement issue. Even though it is only 5 weeks after surgery, I think you are going to require an ectropion repair. It is not a question of if but when. If there is no substantial improvement by three months after surgery, then a lid repositioning procedure is justified given the severity of your problem.

Enophthalmos And/or Hypoglobus After Orbital Floor Fracture? (photo)

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Answer: You May Also Consider Fillers

Answer: You May Also Consider Fillers

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Answer: Lower Eyelid Ectropion Problem After Cheekbone Fracture Repair

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Enophthalmos And/or Hypoglobus After Orbital Floor Fracture? (photo)

Answers (6)

Answer: You May Also Consider Fillers

Answer: You May Also Consider Fillers

Answer: Lower Eyelid Ectropion Problem After Cheekbone Fracture Repair

Answer: Lower Eyelid Ectropion Problem After Cheekbone Fracture Repair

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Recommended reading

Everything you need to know about Eyelid Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.