hypotony?

[zerocool1]

Hi,

As previously stated, I've had a serious head injury which has caused a fracture of in my cribriform plate. Not until 3 years ago did I start noticing dry eyes, eyelid inflammation, lower-eyelid discharge, and my actual eyes getting smaller. I just went to a glaucoma specialist a few days ago to determine if they are actually getting smaller. According to the glaucoma specialist I am 17 in pressure in both eyes. At another doctor I was at 12mmHg 1 year ago. One doctor once said that the eyes can be pulled back after a serious head injury. If so, can this imitate the visual appearance of eyes getting smaller? Also, can the pressure from pulling the eyes back with force by the muscles, etc. cause the eyes to shrink somehow and give a false-positive reading due to the abnormal, localized pressure within the eye (in the front) even when it is actually hypotonous? In other words, pressure is localized in such away in the front part of the eye that it gives a normal reading when in reality it is far less if no force was pulling back(if that is the case). Perhaps I have an underlying infection. I don't know. I just need possible theories not a diagnosis, considering the limitations of internet.

[zerocool1]

Thank you for your response, Dr. McGarity. The head fracture was slightly above the frontal lobes and above the eyes. It radiated, as stated before, down my cribriform plate and right through my middle, left eye orbit. This fracture feels like it opened up too as I can feel the space between the fracutre under my skin that is about 1/4 of an inch.I understand this can create space and cause the left eye to move back. However, I don't understand why I have pain, BOTH eyes themselves seem to be getting smaller quickly overtime, and I have meiobian gland dysfunction (bad quality tears). I'm  concerned the part of the brain that regulates eye function is damaged or an unseen/detectable infection from the sinuses is causing my problems. Its strange that the eye shape (like a partially deflated soccer ball) is changing along with sinking in, giving me the iimpression its the actual eyes somehow getting smaller. Antibiotics and steroids are of no use. Oculoplastic surgeons said they cant do anything for me and I'm about to see a craniofacial surgeon. The plates in my head give bad images for MRI's and I've had many CT scans and am afraid of more radiation at this point.

[Timothy D McGarity, M.D.]

Along with damage to the cribriform plate, were there other facial/cranial fractures present? If you had a complex facial fracture where the zygomaticofacial complex is "pulled away" then it can cause the orbits to enlarge and the eyes will sink into the orbits (eye sockets) more.

Measuring eye pressure is not necessarily related to the pressure or the lack of pressure within the bony eye socket. It's natural for your pressure to vary throughout the day (diurnal IOP variation).

Best wishes,
Timothy D. McGarity, M.D.