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  • Author: Charles NS Soparkar, MD, PhD; Chief Editor: Hampton Roy, Sr, MD  more...
Updated: Sep 30, 2014


Enophthalmos is posterior displacement of the eye. The anterior projection of the eye is most commonly measured relative to the outer edge of the orbit, the orbital rim, but may also be assessed relative to the frontal and maxillary prominences, or the contralateral eye. An image of the eye and orbit anatomy is presented below.

Eye and orbit. Eye and orbit.


Primary enophthalmos indicates a congenital etiology. Some degree of facial asymmetry is common, but congenital relative enophthalmos or ocular retrusion may occur with in utero maldevelopment (eg, plagiocephaly, microphthalmos).

Secondary enophthalmos is due to an acquired change in the volumetric relationship between the rigid bone cavity, the orbit, and its contents (predominantly the orbital fat and the eye). Expansion of the orbital cavity without change in the volume of the orbital contents (ie, a blow-out fracture) leads to enophthalmos.[1] An example of a blow-out fracture is shown in the image below.

Conventional frontal tomograph of a blow-out fractConventional frontal tomograph of a blow-out fracture.

Alternatively, scarring contracture of the orbital fat and extraocular muscles may decrease soft tissue volume, making the orbital cavity less full and causing enophthalmos.




United States

Enophthalmos is common.


Same as in the United States.


Enophthalmos greater than 2 mm relative to the contralateral eye creates an observable cosmetic deformity. Depending on the etiology, other significant morbidity may be associated.


This condition occurs in all ages.

Contributor Information and Disclosures

Charles NS Soparkar, MD, PhD Clinical Associate Professor, Department of Ophthalmology, Baylor College of Medicine; Clinical Specialist, Department of Plastic Surgery, MD Anderson Cancer Center; Deputy Chief, Department of Ophthalmology, Methodist Hospital of Houston

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.

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, Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

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Eye and orbit.
Conventional frontal tomograph of a blow-out fracture.
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