Learning objectives
To review the various techniques and indices that establish the presence of enophthalmos on cross-sectional images.
To offer a systematic approach to the imaging manifestations of traumatic and non-traumatic etiologies of enophthalmos.
To present common,
uncommon,
and rare etiologies of enophthalmos.
Background
Enophthalmos,
as measured on CT and MRI on the axial plane,
is defined as asymmetric posterior displacement of the globe of at least 2 mm of the affected side.
Specifically,
the displacement on the axial plane must be measured at the interzygomatic line where a transversely oriented imaginary line is drawn from one bony zygomatic arch to the other (Fig.
1).
The radiographic measurements for bilateral enophthalmos are still debated in the literature.
However,
ophthalmologic exam defines enophthalmos,
unilateral or bilateral,
as exophthalmometric values of...
Findings and procedure details
TABLE OF CONTENTS/OVERVIEW:
1. Traumatic
- Orbital/Facial Fracture
2. Nontraumatic
- Structural Changes to Orbital Contents
a. Syndromic
b. Vascular
c. Infectious
- Structural Changes to the Globe
a. Phthisis Bulbi (can also be post-traumatic)
b. Anophthalmic
- Globe Retraction
a. Metastatic
b. Congenital
We consider the varied etiologies of enophthalmos in a systematic approach.
Enophthalmos can be traumatic or non-traumatic.
The non-traumatic subset can be further stratified into entities that result in: (1) structural changes to orbital contents,
such as in silent sinus syndrome,...
Conclusion
Enophthalmos is most commonly associated with trauma.
Nonetheless,
in the absence of trauma it can be a marker of underlying serious systemic diseases.
In this pictorial and educational review we present the many etiologies that can result in enophthalmos.
Recognition of enophthalmos clinically and with the aid of cross-sectional imaging can potentially reveal indolent diseases,
leading to timely diagnosis for afflicted patients.
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