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
Sarasota Retina Institute
Sarasota, Florida 34239