Can A High Vertical Orbital Dystopia Be Improved By Thinning Out The Orbital Floor Implant?

Q: Dr. Eppley, I suffered from a orbital floor / medial wall fracture 6 months ago and had the fracture repaired with a silicon implant. However, the repair has resulted in vertical dystopia. My injured eye (left) is now noticeably higher, 1-2mm by guessing, than my right eye. I wanted to ask if this is something that you confidently feel could be corrected. Or, if this is something I should just live with. Thank you.

A: Whether your iatrogenic vertical dystopia could be improved by further surgery is not a judgment that can be made by guessing. A 3D CT scan of the orbit should be done to determine the location and thickness of the orbital floor implant and how the level of the floor compares to the opposite uninjured side. If the thickness of the orbital floor implant is the cause then you would know reliably that thinning it out should lower the over elevated eye.

Dr. Barry Eppley

Indianapolis, Indiana