Orbit

If our eyes are the windows to our souls, the eye socket is the frame - the protective housing that gives structure to our most striking facial feature.

Our eyes sit in sockets (known as orbits) and are surrounded by fibrous tissue, muscles, nerves and fat that help cushion them from damage and aid smooth movement of the eye.

The orbit is made up of 7 bones, some very fine, commonly resulting in fractures due to trauma. These bones are actually designed to readily give way to retract the eyeball away from harm. Apart from damage as a result of injury, a variety of problems can occur in the eye socket and affect the proper functioning of the eye. These issues may require treatment from a skilled Ophthalmologist.

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Conditions and Treatments:

Thyroid Eye Disease

Thyroid Eye Disease (TED) is an associated condition caused when Graves Disease symptoms cause the eye muscles to swell. The disease is usually active for two to three years and requires careful monitoring until stable. Treatment during the active phase focuses on preserving sight and the integrity of the cornea as well as providing treatment for double vision when/if it interferes with daily functioning.

Once in remission, treatment involves correcting permanent damage or issues that may not resolve themselves without surgery, such as:

  • Double vision – Botox injections or surgery may be required to correct a squint that causes blurry or double vision
  • Eyelid retraction – Botox may temporarily assist with a droopy eyelid (Ptosis) or surgery may be required for a more permanent result
    Misalignment of the eyes – Otherwise known as strabismus, whereby typically one eye will correctly focus on an object, whilst the other turns down or away – either intermittently or consistently. Surgery involves a correction of the eye muscles to rebalance or realign their appearance.
  • Returning the eye to a normal position within the socket – Surgery known as orbital decompression involves the removal of fat and/or bones within the orbit to assist with repositioning the eyeball and is generally undertaken as a cosmetic procedure post disease.

Fractures and Implants

The orbit is made up of multiple bones that protect and position your eye. Some orbital bones are paper thin and break relatively easily by design in order to protect the eyeball from injury. A “blowout” fracture is caused by an impact to the front of the eye from something bigger than the eye opening, such as a ball or fist. It occurs when the bony rim of the eye remains intact, but the paper thin floor cracks or ruptures, sometimes trapping tissues and eye muscles. As a result, the injured eye may appear sunken (enophthalmos) and not move normally in its socket causing double vision (diplopia). Surgical implants may be required in order to rebuild and strengthen the orbital structure. This procedure is completed under general anaesthetic and usually requires at least a week to recover.

Tumour

Orbital tumours are most often benign and can occur in any of the tissues that surround the eyeball as well as originate in surrounding sinuses or cavities. Growth of tumours needs to be monitored and surgery may be required should they impact the optic nerve which may lead to a loss of vision. Reassuringly, surgical removal is curative for most orbital tumours and the cosmetic results can be excellent.

Enucleation

On occasions, removal of the eye is required – whether due to pain caused by a non-seeing eye, or perhaps as a result of a tumour. In these cases, a prosthesis implant is used to provide a natural appearance and best possible outcome for the patient. Modern implants become a “living” part of the body due to their porous design which allows blood vessels and tissues to regrow in the socket to minimise rejection or displacement of the prosthesis.

Did you know?… The orbit or eye socket is a triangular prism shaped structure made of bone that provides a stable and protective environment for the eyeball.