H05.4

Clinical Causes: Trauma or injury to the orbit, frequently leading to fractures that allow the eye to sink backward. Post-surgical changes, especially following procedures involving the orbit or sinus surgeries. Enophthalmos caused by atrophy or loss of orbital fat, which can occur with aging or medical conditions such as scleroderma. Chronic inflammatory diseases affecting the orbit, such as thyroid eye disease (though more commonly causing proptosis, sometimes associated with secondary enophthalmos). Orbital tumors or lesions that may displace or compress the contents of the orbit. Congenital abnormalities present from birth affecting the orbital structure. Previous radiation therapy involving the orbit or surrounding facial bones.

Key Symptoms: A visibly sunken appearance of the affected eye(s). Changes in facial symmetry, especially around the eyes. Possible double vision or visual disturbances if the eye position affects visual processing. Restricted eye movement in some cases, depending on the underlying cause. In rare cases, discomfort or a sensation of pressure in the orbital area. Possible associated signs such as eyelid retraction or swelling, depending on the cause.

Diagnosis Path: Diagnosis involves a detailed clinical examination, including assessment of eye position, movement, and appearance. Imaging techniques such as CT scans or MRI scans are essential for visualizing orbital structures, identifying fractures, tumors, or fat loss, and confirming the diagnosis. Differential diagnosis is critical to distinguish enophthalmos from other conditions like proptosis (bulging of the eye). A thorough medical history, including any prior trauma, surgeries, or medical conditions, aids in diagnosis.

Treatment Protocols: Treatment options for enophthalmos depend on the underlying cause and severity. They may include: - Surgical interventions such as orbital reconstruction, orbital fat grafting, or implants to restore the normal position of the eye. - Management of any underlying conditions, such as controlling inflammation or treating tumors. - Cosmetic procedures can be considered for aesthetic concerns or to improve facial symmetry. - In some cases, non-surgical approaches like eye exercises may be recommended, though their effectiveness is limited. Early diagnosis and appropriate treatment are important to address the root causes and minimize complications. Collaboration with specialists such as ophthalmologists, maxillofacial surgeons, or plastic surgeons is often necessary for comprehensive care.