What is Normal 3 Months After Orbital Repair Surgery?

My 9 yo had his right orbital floor repaired w/ an implant. His inferior rectus was released (was hemorragic). It is 3 mos after the surgery, he can see primary and left just fine but he sees doublen when looking down and right. When he looks to the right, his right eye ball seems elevated. His right upper eyelid is puffy in the corner (like a mosquito bite). Our 2nd surgeon said his diplopia and ptosis will resolve in time. A 3rd said we may need to remove the implant. Who is right?

Doctor Answers 1

Orbital floor repair

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I am sorry your son is having trouble after his injury. An orbital floor fracture is a very serious injury and there are many structures in the orbit which can be damaged including bones, nerves and muscles. Repairing a floor fracture helps release material that is trapped in the fracture and helps the bone heal into a more normal position. The surgery can not repair damage to nerves or muscles. Unfortunately, even with surgery, the movement of the eye doesnt always return to normal.


It is hard to make recommendations without examining your son and looking at his scans. Based on what you told me, I would let everything settle in for at least three more months. If a repeat scan shows that the plating material is in good position, I would recommend seeing a pediatric ophthalmologist who may be able to tweak the muscles which move the eye to improve the double vision.

Having children myself, I understand this must very difficult to go through for a parent. I am hopeful that with a little time and possibly some surgery on the eye muscles, the double vision will get better.

Boston Oculoplastic Surgeon
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