Does Fracturing the Orbital Wall Have Any Physical Effects?

I broke my nose and fractured my orbital wall about 10 yrs ago (I was 15). I am unhappy with the crooked appearance of my nose, asymmetrical eyes, and have some breathing problems. Does fracturing the orbital wall have any physical effects? I can't tell if my perceived eye asymmetry is due to my broken nose or the orbital wall fracture.

Doctor Answers 5

Fractured Orbit

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Trauma can significantly affect the volume of your orbit when the walls or floor has been fractured and not repaired. This can have significant effects on the position of your globe in the orbit. Enopthalmos is the term we use to describe an eye that is sunken from its normal position. Conversely these fractures can also cause a decrease in the orbital volume and risk injury to the muscles that move the globe or the globe itself. It is more common to have an increase in orbital volume after facial trauma than a decrease.

In addition to pictures, as Dr. Seify recommends, a CT scan with facial cuts is vital to assess the true impact of your previous fracture. There are many surgical techniques to correct an orbital deformity if one exists and they are usually covered by insurance.

Be sure to find a board certified plastic surgeon.

I hope this helps.

Orbital wall anatomy IS important cosmetically or aesthetically!

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I will assume that you do not suffer from blindness or double vision or other sight problems that might result from orbital trauma. Therefore, I will talk only about the cosmetic end of things.

You did not mention what part of the orbit was involved, so I will discuss the floor which is most commonly fractured due to its thin nature. When this is the case, the fat around the globe may fall down into the sinus. This results in loss of volume of supporting structures of the globe. As a result, the affected eye appears to be sunken in and may look a little lower than the non affected eye.

When the nasal side of the orbit is affected, part of the support to the eyelids may be disrupted (naso-orbito-ethmoid fracture). This will cause the inside corner of the eye to become rounded or blunt, and move out laterally.

If either of the two situations are corrected at the time of the injury, they can usually be fixed. If you wait a long time, they may still be corrected, but it is much more difficult to attain better symmetry.

One way you MAY be able to tell what is causing the asymmetry is to take a photo of yoursef. Draw a vertical line down the middle of the face. Examine left and right side- what do you see?

After you do that, take a piece of paper and cut a triangle large enough to cover the nose. This will help you to focus your attention to just the orbital region. What do you see?

Of course, a plastic surgeon experienced in these reconstructions will also be able to help with the evaluation.

Orbital wall fracture

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Fractures of the orbital wall can change the overall volume of the orbital cavity. But, it really depends upon what part of the orbital wall was fractured, and how bad it was displaced. The lateral and inferior orbital walls are part of the zygoma or cheek bone. If this bone is displaced, it can cahgne the entire contour of the cheek. If the orbital floor or medial wall was fractured, it can cause the eye to sink back in and give a sunken appearance to the eye.

Also, bad fractures, can cause eyeball muscle entrapment which can limit the range of motion of the eye itself. These are just a few of the issues with orbital fractures. An old fracture is much harder to repair because it requires cutting the bone to get it to move.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

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Orbital Fracture

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It is quite possible that you can have visible physical changes after an orbital fracture. However, we would need to see your pictures and scans to completely evaluate your situation. The entire face is in balance, so any change can throw off your symmetry. It is best you go in to your doctor for a complete evaluation.

Fractured orbital floor

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The long term effect of a broken eye socket is related to the eye symmetry, but most importantly, to having double vision. Since your fracture is 10 years old and you have no double vision, the brain might have compensated for this or it was a very mild fracture with no orbital content displacement. For an accurate answer, your pictures need to be reviewed. A good starting point would be a consultation with a board certified plastic surgeon in your area. Good luck

Hisham Seify, MD, PhD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 19 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.