Eye and eye socket injuries occur fairly commonly. Injuries include eyelid laceration, canalicular laceration (tear drain injuries), orbital hemorrhage (bleeding), and orbital fractures (eye socket bone fractures, “blow-out fracture”). They can result from blunt or sharp injuries, including many sport-related activities, falls, assaults, etc. The eyeball itself is also prone to injury and it too needs to be thoroughly.

A “blow out orbital fracture” results from trauma to the orbit and eye area with resultant force causing fracture of the orbit into the adjacent sinuses as the orbital bones are fragile and thin. The most common location of the fracture is the orbital floor followed by the medial wall. Not all orbital (blow out) fractures need to be surgically fixed. Criteria for orbital “blow out” fracture surgery include large fractures, diplopia (double vision), and enophthalmos (sunken eyes). Orbital “blow out” fracture repair should be performed within the first 2 weeks of the trauma. Waiting longer can result in scarring and increased difficulty in the repair with lowered success rate.

Dr. Taban uses the latest minimally invasive technique to repair orbital fractures and has even penned an article about Orbital Wall Fracture Repair Using Seprafilm. Severe eye trauma that causes irreparable eye injury may require eye removal (evisceration or enucleation). Other reasons for eye removal include eye tumors and blind/painnful eyes. Reconstruction of the eye socket to prepare it for a prosthetic eye typically leads to a very pleasing result in addition to the benefits of removing the blinded eye or diseased, painful eye.

Eyelid Laceration and Canalicular Laceration

Eyelid laceration from blunt or sharp trauma is common. Some involve the skin only, while others involve deeper eyelid structures. The canaliculi are the proximal portion of the tear duct drainage system that are located in the eyelids themselves, close to the nose. Trauma can cause laceration or avulsion of the canaliculus. They need to be repaired within 48 hours in order to preserve the tear duct system and avoid irreparable damage.

It is important for someone familiar with the eyelid anatomy to repair these lacerations. The eyelid is made up of many layers and each layer needs to be reconstructed accordingly for best aesthetic and functional outcome.

Left photo shows right orbital blow out fracture with inability to move the eye up. Right photo is 6 weeks after orbital fracture surgery with eye movement restored.

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Before (left) and after (right) of an eyelid laceration.

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Before (left) and after (right) sunken eye surgery.

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Who Should Treat Orbital and Eyelid Trauma?

The orbit is a small, compact and complex structure. The eyelid is also a mobile, complicated structure, made up of many different layers. Oculoplastic surgeons have undertaken the extra training to deal with the nuances of treating orbital and eyelid diseases and injuries. An oculoplastic surgeon, who is a member of American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS), is someone who is a board certified ophthalmologist who has completed additional 2-year fellowship training in cosmetic and reconstructive plastic surgery of the eyelids, orbits (eye socket), lacrimal system( tearing system) and surrounding structures. Dr. Taban is double board certified by American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS), American Academy of Ophthalmology (AAO), and a diplomat of the American Board of Cosmetic Surgery (ABCS).

Dr. Mehryar (Ray) Taban is a board certified ocular-plastic surgeon in Beverly Hills and Santa Barbara with extensive knowledge in the treatment of orbital fractures and eyelid Trauma. To learn more about the different treatment options that may be suitable for you, contact Dr. Taban today to schedule an initial consultation.