eMedicine Specialties > Ophthalmology > Extraocular Muscles

Globe Retraction: Follow-up

Author: Michael T Yen, MD, Associate Professor of Ophthalmology, Department of Ophthalmology, Division of Ophthalmic Plastic, Lacrimal, and Orbital Surgery, Cullen Eye Institute, Baylor College of Medicine
Contributor Information and Disclosures

Updated: Feb 13, 2009

Follow-up

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.
  • 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 recurrences.

Deterrence/Prevention

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

Patient Education

Miscellaneous

Medicolegal Pitfalls

  • Approximately 26% of patients with orbital metastases present with no known history of cancer. Misdiagnosis could lead to delay in appropriate treatment with claims of liability against the ophthalmologist.

Special Concerns

  • Children with orbital floor fractures often present with entrapment of inferior rectus. They should undergo surgical repair within 1 week of initial trauma.
 


More on Globe Retraction

Overview: Globe Retraction
Differential Diagnoses & Workup: Globe Retraction
Treatment & Medication: Globe Retraction
Follow-up: Globe Retraction
Multimedia: Globe Retraction
References
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References

  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. Jun 2008;86(4):356-64. [Medline].

  4. Cepela MA, George CE. Orbital trauma. Curr Opin Ophthalmol. Oct 1997;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. May 1990;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. May-Jun 2008;24(3):233-5. [Medline].

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

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

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

  14. Khan AO, Aldamesh M. Bilateral Duane syndrome and bilateral aniridia. J AAPOS. Jun 2006;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].

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Further Reading

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Keywords

globe retraction, enophthalmos, diplopia, orbital blowout fracture, orbital fracture, orbital trauma, ocular trauma, eye trauma, eye injury, sports injury, retracted globe, Duane retraction syndrome, Duane syndrome, amblyopia, orbital tumor, orbital metastasis, breast cancer, breast carcinoma, lung cancer, lung carcinoma, prostate cancer, prostate carcinoma, metastatic carcinoma

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Contributor Information and Disclosures

Author

Michael T Yen, MD, Associate Professor of Ophthalmology, Department of Ophthalmology, Division of Ophthalmic Plastic, Lacrimal, and Orbital Surgery, Cullen Eye Institute, Baylor College of Medicine
Michael T Yen, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery, American Society of Ophthalmic Plastic and Reconstructive Surgery, and Association for Research in Vision and Ophthalmology
Disclosure: Nothing to disclose.

Medical Editor

Gerhard W Cibis, MD, Clinical Professor, Director of Pediatric Ophthalmology Service, Department of Ophthalmology, University of Kansas, Kansas City
Gerhard W Cibis, MD is a member of the following medical societies: American Academy of Ophthalmology, American Association for Pediatric Ophthalmology and Strabismus, and American Ophthalmological Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

J James Rowsey, MD, Former Director of Corneal Services, St Luke's Cataract and Laser Institute, Florida
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, Pan-American Association of Ophthalmology, Sigma Xi, and Southern Medical Association
Disclosure: Nothing to disclose.

CME Editor

Lance L Brown, OD, MD, Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri
Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD, Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences
Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology
Disclosure: Nothing to disclose.

 
 
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