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sinking eye from head injury years ago
Hello,
I'm a 27 year old male. I had a left frontal lobe head injury with a bat which caused a skull fracture and required pulling my face and head skin back to fix, back in 2002. I saw an ocular plastic surgeon that had me do a CT scan w/o contrast because I saw that one eye was sinking and the other was protuding. My question is: will my eye keep sinking back and is this reversible? because since Febuary of this year it seems that my left eye keeps sinking back. My right eye is slightly protuded but its stable; both upper eyelids are slightly puffy. I also get a white discharge at the corners of my eyes sometimes, with eye pain inside the eye along with a sore throat I've had for over a year now. My ears also pop. After the CT scan, the ocular plastic surgeon said my eye was going back because of a fracture in the orbit. Here's the CT scan result by a neuroradiologist:
"There is encephalomalacia in the left anterior and inferior lefter greater than right frontal lobes compatible with old contusions. There is film cut off paranasal bone. There is mucosal thickening of multiple ethmoidal air cells with opacification of the left middle ethmoidal air cell. There is a defect in the left frontal bone. There is minimally depressed fracture fragment measuring 4mm in length adjacent to the frontal sinus. there is a left frontal craniotomy defect. the fracture involves the left frontal bone. there is small plat and screws fixating the bifrontal craniotomy defect. there is deformity of the left cribriform plate. there is opacification of the left ethmoidal air cells which in conjunction with the defect of the left cribriform plate is worrisome for CSF leak. there is a fracture through the superior to the superior and through the meatal aspect of the superior wall of the left orbit. there is also deformity of the right cribriform plate with a questionable defect through the anterior and inferior cribriform plate. The lacrimal glands are symmetric in size. there is no enlargement of the extraocular muscles or crowding in the orbital apices,
Impression:
1.comminuted fracture of the left frontal bone involving the superior wall of the left orbit with a defect through the left cribriform plate.
2.Encephalomalacia in the left greater than right inferior right frontal lobes compatible with old contusions.
3. A deformity with a questionable defect through the right cribriform plate
4. The findings are worrisome for a CSF leak given the opacification of several left ethmoidal air cells and a defect through the left cribriform plate.
5. Bifrontal craniotomy defect.
6. No retrobulbar induration, gross retrobulbar mass
7. Continued followup including a neurosurgical consultation may be helpful given the defect of the cribriform plate."
Could all this cause death or blindness, too? I'm currently trying to find a neurosurgeon.
Thank you very much, in advance, for your response.
I'm a 27 year old male. I had a left frontal lobe head injury with a bat which caused a skull fracture and required pulling my face and head skin back to fix, back in 2002. I saw an ocular plastic surgeon that had me do a CT scan w/o contrast because I saw that one eye was sinking and the other was protuding. My question is: will my eye keep sinking back and is this reversible? because since Febuary of this year it seems that my left eye keeps sinking back. My right eye is slightly protuded but its stable; both upper eyelids are slightly puffy. I also get a white discharge at the corners of my eyes sometimes, with eye pain inside the eye along with a sore throat I've had for over a year now. My ears also pop. After the CT scan, the ocular plastic surgeon said my eye was going back because of a fracture in the orbit. Here's the CT scan result by a neuroradiologist:
"There is encephalomalacia in the left anterior and inferior lefter greater than right frontal lobes compatible with old contusions. There is film cut off paranasal bone. There is mucosal thickening of multiple ethmoidal air cells with opacification of the left middle ethmoidal air cell. There is a defect in the left frontal bone. There is minimally depressed fracture fragment measuring 4mm in length adjacent to the frontal sinus. there is a left frontal craniotomy defect. the fracture involves the left frontal bone. there is small plat and screws fixating the bifrontal craniotomy defect. there is deformity of the left cribriform plate. there is opacification of the left ethmoidal air cells which in conjunction with the defect of the left cribriform plate is worrisome for CSF leak. there is a fracture through the superior to the superior and through the meatal aspect of the superior wall of the left orbit. there is also deformity of the right cribriform plate with a questionable defect through the anterior and inferior cribriform plate. The lacrimal glands are symmetric in size. there is no enlargement of the extraocular muscles or crowding in the orbital apices,
Impression:
1.comminuted fracture of the left frontal bone involving the superior wall of the left orbit with a defect through the left cribriform plate.
2.Encephalomalacia in the left greater than right inferior right frontal lobes compatible with old contusions.
3. A deformity with a questionable defect through the right cribriform plate
4. The findings are worrisome for a CSF leak given the opacification of several left ethmoidal air cells and a defect through the left cribriform plate.
5. Bifrontal craniotomy defect.
6. No retrobulbar induration, gross retrobulbar mass
7. Continued followup including a neurosurgical consultation may be helpful given the defect of the cribriform plate."
Could all this cause death or blindness, too? I'm currently trying to find a neurosurgeon.
Thank you very much, in advance, for your response.
MEDICAL PROFESSIONAL
I'm sorry but your case is too complicated to be more specific.
JCH MD
JCH MD
What I noticed too is that when I squint, both eyes move up along with the squint of the lower eyelid. Its obvious that when I squint that they both move up. Does this mean anything? Thanks, in advance, Dr., for your response.
Dr. Hagan,
Thank you for your response. What I forgot to mention is that in 2002 when this head injury occured, I was never told about having a fracture in my orbit. Unfortunately,I was hit in the eye again in 2006; I didnt see a Dr. or do CT scan for 2006. In the current CT scan the fracture in the orbit continues from the old fracture. I suspect this fracture has been undetected in 2002 and is continuing to crack. My left eye has literally taken a "pinched, squeezed"-look on one side and seems to keep sinking; its no longer sperical as it should be.I'm getting a second opinion from another ocular plastic surgeon Thursday because my current one seems incompetent; she thinks the fracture is from the past, but my symptoms are getting worse as if its a new fracture.My eyes are very dry now and a white discharge occumalates and burns throughout the day. I dont know if the cribriform plate deformity could also affect my right eyeball because it seems kind of more swollen. In other words, can an orbital fracture on one side cause problems on the other eye?
Is this pinched look permanent and could it affect my vision if the "dent" keeps reaching my iris?.
Thank you for your response. What I forgot to mention is that in 2002 when this head injury occured, I was never told about having a fracture in my orbit. Unfortunately,I was hit in the eye again in 2006; I didnt see a Dr. or do CT scan for 2006. In the current CT scan the fracture in the orbit continues from the old fracture. I suspect this fracture has been undetected in 2002 and is continuing to crack. My left eye has literally taken a "pinched, squeezed"-look on one side and seems to keep sinking; its no longer sperical as it should be.I'm getting a second opinion from another ocular plastic surgeon Thursday because my current one seems incompetent; she thinks the fracture is from the past, but my symptoms are getting worse as if its a new fracture.My eyes are very dry now and a white discharge occumalates and burns throughout the day. I dont know if the cribriform plate deformity could also affect my right eyeball because it seems kind of more swollen. In other words, can an orbital fracture on one side cause problems on the other eye?
Is this pinched look permanent and could it affect my vision if the "dent" keeps reaching my iris?.
MEDICAL PROFESSIONAL
Death from an injury in 2002. Not likely. Blindness not likely. could it sink in further yes it could. repair can be very difficult
JCH MD
JCH MD
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