Enophthalmos and exophthalmos antagonism, although not as clinically significant as exophthalmos, excessive inward invasion can prevent the eyelid and cornea from maintaining contact, leading to corneal dryness.

bubble_chart Etiology

Common causes include:

1. Small eyeball: such as congenital microphthalmia and acquired eyeball atrophy.

2. Sympathetic nerve paralysis: causes relaxation and paralysis of the orbital Miller muscle and intraorbital smooth muscles, resulting in grade I ptosis of the upper eyelid, narrowing of the palpebral fissure, and inward invasion of the eyeball. Additionally, due to paralysis of the dilator pupillae muscle, the pupil constricts. These three symptoms are collectively known as Horner syndrome.

3. Loss of orbital fat: commonly seen in the elderly after severe illness, leading to progressive hemifacial atrophy and progressive fat loss, or after removal of orbital tumors or absorption of hemorrhage.

4. Trauma: often caused by orbital floor fracture, which enlarges the orbital cavity or allows part of the contents to enter the maxillary sinus, resulting in acute traumatic inward invasion of the eyeball. Furthermore, even without bone trauma, chronic traumatic inward invasion of the eyeball can occur due to progressive organization and contraction of retrobulbar tissues.

5. Overcontraction of rectus muscles: seen after strabismus surgery, where excessive shortening of a particular muscle leads to inward invasion of the eyeball, or due to orbital membrane inflammation, involving the ocular muscles and muscle membrane, causing paralytic contraction and resulting in inward invasion of the eyeball.

bubble_chart Diagnosis

2. Horner syndrome is caused by paralysis of the cervical sympathetic nerve, with symptoms such as miosis and inward invasion of the eyeball.

3. Caused by orbital fracture, eyelid skin lowering qi swelling, with crepitus, inward invasion of the eyeball, and X-ray can confirm the fracture.

bubble_chart Treatment Measures

There is no effective treatment for eyeball inward invasion, and the main approach is symptomatic management.

1. For cases of cervical sympathetic nerve paralysis, treat the underlying disease cause.

2. For those with traumatic fractures, surgical intervention may be necessary when required.