The World Around The Eyeball

The Orbit

The orbit, or eye socket, is the cavity which holds the eye and its surrounding structures (such as muscles and fat) .  Except for the front, it is surrounded on all sides by bone.  The orbit is like an ice cream cone with the “ice cream” scoop facing front instead of “up.”  The ice cream scoop is the “eye.”  The bones on the side near the nose and underneath the eye are very thin, while the bone on the outside near the ear is the thickest. The bone at the top and the back of the orbit separate the orbital contents from the brain. The bones along the floor and wall near the nose are very thin and separate the orbit from the sinuses. Sinuses are areas in the skull that are filled with air. This keeps the head lighter and also better protects the face in the case of trauma.

Orbital Fractures

In fact, the bones of the orbit are thin so if the eyeball is struck, the thin bones will break prior to the eyeball itself breaking.  These orbital fractures can cause double vision, pain around the eye, or even no symptoms at all. Oculoplastic surgeons, such as Dr. Spoor or myself, specialize in fractures of the bones in the orbit. All breaks of the orbital bones do not have to be fixed, only when there are problems from the break.

Tumors Of The Orbit

Tumors can grow inside the orbit causing damage to the eye or its surrounding structures. The tumors can primarily grow inside the orbit, such as a cavernous hemangioma or can metastasize from other cancers in the body. The orbit is a tight space.  As tumors grow, softer tissues get compressed and the eye can get pushed out.  This can cause the eye to bulge out, decreased vision, pupil changes, and even long standing redness of the eye. When a mass is suspected an xray, CT scan or MRI is used to help find the mass. Sometimes the imaging can help make a diagnosis of the mass,  but other times surgery is needed to fully diagnose the lesion. There are multiple approaches used depending on the location. Sometimes the lesion can be removed entirely and sometimes a biopsy is taken and the lesion treated with medications.

The orbit is a incredible area that contains the eyes and its surrounding structures. It can suffer damage from trauma or even tumors. It is important to have any orbital problems addressed by oculoplastic specialists, doctors well versed and comfortable working in side and around the orbit. Dr. Abrams, Levy, and Spoor are orbital surgeons who commonly work in this small yet amazing area.  If you or someone you know have any questions, please leave a comment or give us a call at 941-921-5335.

 

 

Jody Abrams, MD, FACS
Oculoplastics/Neuro-ophthalmology
Sarasota Retina Institute
Sarasota, Florida 34239

Comments

  1. Sandie Herron says:

    Dr. Abrams,

    Thank you for pointing out this article to me. Just this morning I caught up on other articles, including the archives. It is all very fascinating. Since there is “something” that runs through our family, it is even more interesting. My niece (older brother’s second child, first girl) had eyes so crossed, she needed surgery before her first birthday to correct it. I think of her as lucky since I’ve been struggling with eye problems for decades. It’s only gotten intolerable in the past five years.

    I switched ophthalmologists this year to Wayne Golden, and found him friendly and competent. What really made him unique was that his practice offered a money-back guarantee for 30 days on the eyeglasses. With prisms in my eyeglasses and every eye doctor I’ve seen having a different opinion on what that measurement should be, I did go back in a week to be retested. In the end I had 20/20 vision. Since we believe much of my problem is caused by autoimmunity (I have many other AI problems), we think my eye problems are as well. It makes it even harder to diagnosis since I may have some of the symptoms of Graves disease, but not all and some are adverse to what is commonly attributed to the disease. So I am dx’d with “thyroid eye disease” or crossed eyes (can’t remember dx for that one).

    I see Dr. Levy in five months or so, and I will be asking him about the “eyelid tuck”. I do have the desire to almost put toothpicks in my eyes to hold the eyelids up and open so I could see better. I constantly look like I am asleep since my eyelids are half closed all the time. My older brother had this problem as well. Unfortunately I am estranged from my brothers, the only family I have left.

    Thank you so very much for your personal attention. Keep those articles coming. They’re informative and understandable. If you feel that a different approach or sooner visit with Dr. Levy (or you) is necessary, please let me know.

    Sandie

    Sandie Herron
    Sarasota, FL 34232-2356 USA

    PS It seems that everyone is making the fonts they use on the computer smaller. I could not read what you wrote below without using the zoom feature. You might wish to consider making your type larger or writing an article on how to deal with it for the lay person.

    • Jody Abrams, M.D. says:

      Ms Herron,
      I am glad that you have enjoyed our articles. I think one of the best things that the internet has done for medicine is allow us to further educate our patients. While we try in the clinic to help people understand their problems, when they can then read about it online it helps solidify the information.
      I would defiantly talk with Dr Levy about getting your eyelids addressed. As far as the crossing of your eyes I am sure you have had Rikki working with you on prisms. She can work with Dr Golden if he needs to help refine the prism as needed.
      As for the size of the font I think you can change that on your browser settings. I will try to increase it hear but I think it is controlled a lot by the user also. If I am around the clinic next time you are in ask them to grab me and I can show you how to set this.

      Have a great new year.
      Jody Abrams, MD

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