Fractures of the bony orbit (the eye socket) are typically caused by a blow to the eye. Common mechanisms of injury include assault, motor vehicle accidents, falls, and sports injuries. Orbital fractures are often isolated (confined to the socket alone), with bone fragments displaced into the surrounding sinuses. In such situations, they are often referred to as “blowout” fractures. In other cases, they can be associated with fractures of other parts of the face, such as the nose, the cheekbone, or the maxilla (upper jaw). When these so-called facial “buttresses” are fractured, it is often necessary to repair them before or at the same time as fracture repair inside the orbit. The risks associated with orbital fractures include double vision (diplopia), sunken eye (enophthalmos), and rarely orbital infection.
Orbital abscesses can be very dangerous. Because the orbit is a small enclosed compartment, the abscess can increase pressure on the orbital tissues and cause damage to the eye and/or optic nerve – causing blindness! Also, because the orbit is so close to the brain, with direct conduits through bone into the brain cavity (cranium), orbital cellulitis and abscesses can spread and affect the brain. Therefore, treatment of orbital cellulitis is considered an emergency.
Graves’ disease is an autoimmune condition in which immune cells attack the thyroid gland, which in turn responds by secreting an excess amount of thyroid hormone. As a result, the inflamed thyroid gland can enlarge (“goiter”) and excess hormone changes metabolism and affects the function of the heart, brain and other organs. The eyes are particularly vulnerable to thyroid disease, because the immune system that attacks the thyroid gland often also targets the eye muscles and connective tissue within the eye socket. The skin is also affected, but to a lesser degree in most patients.