Although fracture has always been regarded as a cause of enophthalmos, there exists in the literature considerable speculation on the mechanism of the displacement of the eye when there is no external evidence of fracture. Most of the discussion on the sometimes distressing consequences of a blow on the eyeball took place before the roentgen rays were developed to a high point of usefulness. To many of the early observers fracture meant fragmentation and gross deformity. It was inconceivable to them that the eyeball could receive, withstand and transmit a blow forceful enough to fracture any of the walls of the orbit. Since means of demonstrating deep, or internal, fractures were lacking and, in later years, since roentgenography was not employed at its greatest efficiency, enophthalmos in many cases was considered an extraordinary phenomenon. Today, with the roentgen rays, one is able to study the orbit in fairly minute detail,
PFEIFFER RL. TRAUMATIC ENOPHTHALMOS. Arch Ophthalmol. 1943;30(6):718–726. doi:10.1001/archopht.1943.00880240032002
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