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Should I Have the Surgery to Repair a Fractured Orbital Floor? (photo)

On Sunday, I was jumped by two guys and they fractured the orbital floor of my left eye. I have seen two doctors now that both agree that I am in the gray area as far as needing the surgery. One said he would probably do it, the other said he probably wouldn't. My question is if I didn't get the surgery and later on the eye did sink, what exactly am I going to be looking at? Is it going to be very noticeable and make me look deformed or is it the kind of thing you wouldn't really notice?

Doctor Answers 2

May 28th, 2012

Orbital floor fractures

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I treat a lot of orbital floor fractures. In my opinion, if the floor fracture is fairly large, or you have enophthalmos( the eye sinks back and appears smaller) or you have entrapment( the eye does not move freely upward usually), then you need surgery.  If you delay it, the muscles contract and it is difficult to impossible to  correct the enophthalmos.  Good luck.

Steven Wallach, MD
May 26th, 2012

The photograph means nothing.

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There are some findings that are potentially significant from the eye exam regarding double vision and the presence of restriction of eye movement.  However, the CT scan has become the single most important tool in deciding if one needs to have repair of the orbit fracture.  If the orbital floor is sufficiently expanded that it is more likely than not that the injured side will be more than 2 mm enophthalmic or sunken, surgery should be performed.  Regarding the timing of surgery: the earlier the better.  I suggest that you consider being assessed in a University setting by an oculoplastic surgeon.  The American society for ophthalmic plastic and reconstructive surgery maintains a geographic directory of highly qualified surgeons on their website (asoprs dot org).  If you a fortunate enough to live near a medical school with a department of ophthalmology, they most likely have an oculoplastic surgeon on staff.  It is worth your while to have an urgent consultation.  Waiting to have this repair is a bad idea.  By that time scaring makes it  very difficult to have an adequate correction.

Kenneth D. Steinsapir, MD

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

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