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Orbit question for Eye Docs

Old 02-13-2018, 08:37 AM
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Default Orbit question for Eye Docs

If someone had a damaged or distorted lower orbit would a regular ophthalmic exam discover this or would you need imaging?
Old 02-13-2018, 10:21 AM
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Calling all non-eye docs who stayed at a Holiday Inn express last night....
Old 02-13-2018, 10:27 AM
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The orbit can describe the bone in which the eye and associated components reside or can collectively mean the bone and muscle group. I doubt that a normal exam could diagnose any more than an anomaly in the function of the eye. It would take an x-ray and/or MRI to determine any more.

Besides being Garett's Financial and Spiritual Advisor, I'm also a world renowned ophthalmologist.
Old 02-13-2018, 10:32 AM
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Originally Posted by airbrush View Post
The orbit can describe the bone in which the eye and associated components reside or can collectively mean the bone and muscle group. I doubt that a normal exam could diagnose any more than an anomaly in the function of the eye. It would take an x-ray and/or MRI to determine any more.

Besides being Garett's Financial and Spiritual Advisor, I'm also a world renowned ophthalmologist.
Specifically the structure of the bone in the lower orbit above the max sinus.
Old 02-13-2018, 02:23 PM
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The dr may be seeing some bruising and/o swelling in the lower orbit. Also, they may see some restriction in the movement of the eye. At any rate, x-ray or mri will tell the tale.
Old 02-13-2018, 04:13 PM
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Originally Posted by joe.giuliano View Post
If someone had a damaged or distorted lower orbit would a regular ophthalmic exam discover this or would you need imaging?
No eye physician here, but I do know a few things about the Orbit. (And the eyes for that matter)

I defer to any real eye physician, when one shows up.

The extraocular muscles (four of them) work in synergy to allow you to look around. If the lower part of the orbit traps the muscle or it's sheath you could have diplopia (double or blurred vision) when looking in certain directions. A simple exam could show this. "Follow my finger and look at this....etc" Looking up or down may exhibit these symptoms, but side to side could also be affected.

Pain could also be localized to the area below the eye. This could be elicited during a causal exam

The only real way to determine the extent of injury, or damage to the lower orbit is via imaging. (X-ray CT MRI, etc)

Sinusitis or abscesses can destroy the orbital structures. (In very bad cases) Tumors can too. Fractures can also happen. The orbital bones have the strength of a saltine cracker. They are thin and can crack and fracture. If this occurs with displacement, you can have visual symptoms.
Pressure on the globe is also a bad thing. It can cause visual disturbances, imperil the blood flow to the retina, and all kinds of other bad stuff.

Good luck. A real opthalmologist or other ocular specialists is a good idea when suspicious of orbital issues.
Old 02-13-2018, 04:29 PM
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Actually there are six muscles involved in controlling eye movements. Sometimes an orbit fracture can be diagnosed simple physical examination revealing limited external eye movement secondary to the body of one of these muscles being trapped in a blown out area of the orbit. Plain X-rays help, but thin slice CT scanning of the orbit is the best way to determine what's going on. MRI doesn't show the bony details as well as CT scanning so it has a much more limited role in assessing eye trauma.
Old 02-13-2018, 05:32 PM
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Thanks dssmith and flcather1. Trying to determine if it is sinusitis damage or orbit causing blockage of cavity. CT scan scheduled soon. hoping to avoid orbital reconstruction.
Old 02-13-2018, 05:35 PM
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Originally Posted by joe.giuliano View Post
Thanks dssmith and flcather1. Trying to determine if it is sinusitis damage or orbit causing blockage of cavity. CT scan scheduled soon. hoping to avoid orbital reconstruction.
A result of your previous injury?
Old 02-13-2018, 06:01 PM
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Yes CT of the orbits is the proper study.
Old 02-13-2018, 07:37 PM
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Flcatcher is correct on the number of muscles. Good thing I'm retired.

Either way, best to check it out. Eyes are too important to neglect.

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