Orbital wall defects

Orbital floor and medial wall defects, or their combination are commonly occurring posttraumatic deformities.

Untreated or undertreated orbital wall fractures producing volume enlargement are common causes of enophthalmos.

This may result from either isolated wall fractures (blow-out fractures) or from fractures affecting the orbital rim (infraorbital rim, naso orbital ethmoidal, zygoma).

Patients with posttraumatic enophthalmos present with the following clinical findings:

• Posterior (axial) globe displacement
• Pseudoptosis
• Supratarsal fold deepening

In some patients enopthalmos may be associated with hypophthalmos (inferior globe displacement), caused by inferior displacement of the orbital floor at the level of the globe equator.

Patients with an associated orbitozygomatic deformity may present with the following additional features:

• Depression of the malar eminence
• Midface widening
• Inferior displacement of the lateral cantus
• Cheek ptosis