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Globe Retraction Follow-up

  • Author: Michael T Yen, MD; Chief Editor: Andrew G Lee, MD  more...
Updated: Mar 15, 2016

Further Outpatient Care

Patients with Duane syndrome should be observed for development/worsening of strabismus, anomalous head position, or amblyopia.

Patients with orbital blowout fractures should be observed for persistent diplopia and development of enophthalmos. Some patients may benefit from medical therapy in the acute setting (antibiotics, nasal decongestants, steroids). Patients with severe enophthalmos may require reconstructive orbital surgery.

Patients with metastatic tumors of orbit treated with radiation therapy should be observed for development of keratitis, dry eye, cataract, or radiation retinopathy. All patients with orbital metastases should be monitored to assess for evidence of recurrence and evaluated and treated systemically by an oncologist (eg, chemotherapy, radiation therapy, surgery).

Silent sinus syndrome may respond to medical therapy or may require surgery.



Protective eyewear should be worn during participation in high-risk activities.


Patient Education

For excellent patient education resources, visit eMedicineHealth's Eye and Vision Center. Also, see eMedicineHealth's patient education article Eye Injuries.

Contributor Information and Disclosures

Michael T Yen, MD Professor of Ophthalmology, Division of Ophthalmic Plastic, Lacrimal, and Orbital Surgery, Cullen Eye Institute, Medical Director, Alkek Eye Center, Co-Director, BCM Aesthetics, Program Director, ASOPRS Fellowship, Baylor College of Medicine

Michael T Yen, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Ophthalmic Plastic and Reconstructive Surgery

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

J James Rowsey, MD Former Director of Corneal Services, St Luke's Cataract and Laser Institute

J James Rowsey, MD is a member of the following medical societies: American Academy of Ophthalmology, American Association for the Advancement of Science, American Medical Association, Association for Research in Vision and Ophthalmology, Florida Medical Association, Sigma Xi, Southern Medical Association, Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

Chief Editor

Andrew G Lee, MD Chair, Department of Ophthalmology, Houston Methodist Hospital; Clinical Professor, Associate Program Director, Department of Ophthalmology and Visual Sciences, The University of Texas Medical Branch; Clinical Professor, Department of Surgery, Division of Head and Neck Surgery, University of Texas MD Anderson Cancer Center; Professor of Ophthalmology, Neurology, and Neurological Surgery, Weill Medical College of Cornell University; Clinical Associate Professor, University of Buffalo, State University of New York School of Medicine

Andrew G Lee, MD is a member of the following medical societies: American Academy of Ophthalmology, Association of University Professors of Ophthalmology, American Geriatrics Society, Houston Neurological Society, Houston Ophthalmological Society, International Council of Ophthalmology, North American Neuro-Ophthalmology Society, Pan-American Association of Ophthalmology, Texas Ophthalmological Association

Disclosure: Received ownership interest from Credential Protection for other.

Additional Contributors

Gerhard W Cibis, MD Clinical Professor, Director of Pediatric Ophthalmology Service, Department of Ophthalmology, University of Kansas School of Medicine

Gerhard W Cibis, MD is a member of the following medical societies: American Academy of Ophthalmology, American Association for Pediatric Ophthalmology and Strabismus, American Ophthalmological Society

Disclosure: Nothing to disclose.

  1. Britt MT, Velez FG, Thacker N, Alcorn D, Foster RS, Rosenbaum AL. Surgical management of severe cocontraction, globe retraction, and pseudo-ptosis in Duane syndrome. J AAPOS. 2004. 8:362-367. [Medline].

  2. Chua B, Johnson K, Donaldson C, Martin F. Management of Duane retraction syndrome. J Pediatr Ophthalmol Strabismus. 2005. 42:13-17. [Medline].

  3. Athanasiov PA, Prabhakaran VC, Selva D. Non-traumatic enophthalmos: a review. Acta Ophthalmol. 2008 Jun. 86(4):356-64. [Medline].

  4. Cepela MA, George CE. Orbital trauma. Curr Opin Ophthalmol. 1997 Oct. 8(5):64-9. [Medline].

  5. Putterman AL, Smith BC, Lisman RD. Blowout fractures. In: Nesi FA, et al, eds. Smith's Ophthalmic Plastic and Reconstructive Surgery. 2nd ed. 1998:209-23.

  6. Remulla HD, Bilyk JR, Rubin PA. Pseudo-entrapment of extraocular muscles in patients with orbital fractures. J Craniomaxillofac Trauma. 1995. 1:16-29. [Medline].

  7. Goldberg RA, Rootman J. Clinical characteristics of metastatic orbital tumors. Ophthalmology. 1990 May. 97(5):620-4. [Medline].

  8. Rootman J, Ragaz J, Cline R, et al. Tumors: Orbital metastasis. In: Rootman J, ed. Diseases of the Orbit. 1988:405-26.

  9. Tijl J, Koornneef L, Eijpe A, et al. Metastatic tumors to the orbit--management and prognosis. Graefes Arch Clin Exp Ophthalmol. 1992. 230(6):527-30. [Medline].

  10. Alsuhaibani AH, Carter KD, Nerad JA, Lee AG. Prostate carcinoma metastasis to extraocular muscles. Ophthal Plast Reconstr Surg. 2008 May-Jun. 24(3):233-5. [Medline].

  11. Mombaerts I, Goldschmeding R, Schlingemann RO, Koornneef L. What is orbital pseudotumor?. Surv Ophthalmol. 1996 Jul-Aug. 41(1):66-78. [Medline].

  12. Strachan IM, Brown BH. Electromyography of extraocular muscles in Duane''s syndrome. Br J Ophthalmol. 1972 Aug. 56(8):594-9. [Medline].

  13. Shields CL, Shields JA. Metastatic tumors to the orbit. Int Ophthalmol Clin. 1993 Summer. 33(3):189-202. [Medline].

  14. Khan AO, Aldamesh M. Bilateral Duane syndrome and bilateral aniridia. J AAPOS. 2006 Jun. 10(3):273-4. [Medline].

  15. Oohira A, Masuzawa K. A case of congenital oblique retraction syndrome with upshoot in adduction. Strabismus. 2002. 10:39-44. [Medline].

Patient presented with persistent diplopia after an interpersonal altercation. Forced ductions revealed tight inferior and medial rectus muscles on right side. CT scan revealed orbital floor and medial wall fractures in right orbit.
Patient with metastatic breast carcinoma to the intraconal space of the right orbit resulting in mild globe retraction and enophthalmos.
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