Q: Dr. Eppley, I am interested in eye asymmetry surgery. A few months ago I fainted and fell against a sink. The result was a left eye broken orbit (only the rim below, not a blow out fracture, no displacement). After a few weeks when the swelling was gone, I saw that the position of my left eye was different from the right side. Doctors measured a different of the position of the globe of 1.5 mm. Although it might not be much, in my case it is obvious. Doctors told me that it could be from fat atrophy. Do you think that an implant or so can help me to get my eyes more symmetric again? Many thanks for your response!
A: If an eye asymmetry has indeed developed after some type of orbital fracture, particularly if occurring within the first month after the injury, I would have it assume that this is due to a skeletal issue not fat atrophy. (as that would take many months or even years to be seen) But regardless of its cause a horizontal globe asymmetry can be treated by one of two methods, an implant or fat grafting. A small implant can be used to build up the orbital floor or a dermal-fat graft can also be so placed. (if you happen to have a c-section from your children) This is a simple surgery in which either material can be placed through a limited subciliary or transconjuncitival incision. The hard part is just deciding if such surgery is absolutely necessary and what material to use in doing it should it be so. Please send me a picture of your eyes showing their current state.
Dr. Barry Eppley