Sunken Eye Orbital Fracture? (photo)

I was punched in the eye 10 years ago. I'm not sure if it's my eyelid or eye socket that was damaged I think my left eye is depressed slightly downward and is positioned slightly higher than my right eye, but I saw a plastic surgeon in LA who is a oculoplastic surgeon who has done eyelid surgeries and complex orbital fracture repair who said he thinks left eyelid is lazy and it's making my right eye appear larger. He still recommended to get a CT scan to rule. what do you think?

Doctor Answers 6

Definitely need CT

Agree with others.


1. You need a CT scan of the facial bones/orbits. Need to look for evidence of other previous fractures so that you can be treated correctly

2. You need an Ophthalmology exam.  Specifically (provided no depressed cheek bone fracture) to get a hertel Exophthalmometer reading.  This measurement will tell you if you have a significant difference between the two eyes.

3. If you are not having trouble with vision ie double vision, really consider carefully if you want to do anything at all.  As a surgeon that frequently treats facial fractures, delayed orbital fractures can be difficult and come with a risk (albeit tiny) of blindness in the affected eye.


cheers and good luck.

Washington DC Plastic Surgeon
3.4 out of 5 stars 5 reviews

Eyelid surgery

I agree a CT scan is necessary to evaluate the boney structure of the orbits. Without the CT it will be difficult to decide what is causing the asymmetry.

Gregory Sexton, MD
Columbia Plastic Surgeon
4.9 out of 5 stars 73 reviews

CT scan is appropriate

I was able to magnify your photos to better evaluate the eye position, and I do get the impression that the right eye is slightly more prominent [bulgy] than the left eye [or put another way, the left eye is slighty more sunken in].

The difference is subtle, and difference within 2 mm is considered to be within the normal range.

I do not appreciate a "lazy eye" from the photos, but that may be something that your surgeon may have picked up on an eye exam.

A CT scan is very reasonable next step to better appreciate the difference in anatomy.

A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 37 reviews

Sunken Eyes

It's difficult to see much with these photos.  Your left eye appears deviated inward.  A CT is reasonable, but there is radiation exposure with a CT.  I would consider seeing an ophthalomologist who specializes in strabismus, "lazy eyes",  before having the CT.  This way you may avoid the radiation.

Steven J. Covici, MD
Springfield Oculoplastic Surgeon
4.3 out of 5 stars 15 reviews

Sunken Eye Orbital Fracture?

I agree that you should get a CT scan to evaluate what is going on regarding your orbit.  Your photos aren't good enough to give you an opinion regarding the cause of the eye asymmetry. 

Sam Goldberger, MD
Beverly Hills Oculoplastic Surgeon
4.7 out of 5 stars 16 reviews

CT Scan after Trauma

    Get the CT scan.  It is best to have all of the information at your disposal before considering a surgery that may not fix your problem.  You do not have pictures of your cheek included but a ZMC fracture or orbital fracture can produce orbital volume changes that should be addressed due to functional issues or cosmesis.  If the eyeball is sunken and given the mechanism, the most likely conclusion would be fracture to increase the volume of the orbit.  Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 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.