Please Help with Orbital Asymmetry

I have orbital asymmetry of the globes themselves. I dont have a fracture, no sinking sinus syndrome. I believe it is a congenital anomaly that has just gotten worse over the last 10 years. I have double vision currently. Tarsal strip surgery in the past to mask asymmetry but it's gotten worse sense then too. Hoping for orbital implant to correct. 

Doctor Answers 2

Orbital Asymmetry Requires Further Work-Up And Evaluation

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Your orbital asmmetry can be the result of two different problems. Proptosis from thyroid disease is one possibility as even the 'normal' right eye seems a bit bulgy. I would have your thyroid function fully evaluated first. If this is the problem then orbital decompression is needed. If your thyroid workup is negative, then the orbital asymmetry is undoubtably skeletal in nature with differences in the shape and horizontal position of the orbits. I would first get a 3-D CT scan to accurately make that diagnosis. Whether an orbital implant will work depends on how much orbital space exists. It is usually not just as simple as pushing the eyeball upward as there is no space for it to go and the eyeball does not tolerate being compressed.

Orbital proptosis

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You appears to have proptosis (buldy eyes), likely congenital as you say.  This has to do with relative shallow orbits and poor maxillary bony support.  The other common reason for proptosis is thyroid eye disease.  In regards to treatment, the best option is usually orbital decompression. Malar implant is an option as well but not as good.  Connsult an oculoplastic surgeon.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 91 reviews

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