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May 1948


Author Affiliations

From the Institute of Ophthalmology of the Presbyterian Hospital, and the Department of Ophthalmology, Columbia University, College of Physicians and Surgeons.

Arch Ophthalmol. 1948;39(5):595-622. doi:10.1001/archopht.1948.00900020604004

In this paper I shall describe a not infrequently neglected deformity, present typical case reports of the condition in its various degrees of extent, evaluate the various methods of treatment which have been advocated and describe in detail the treatment which has proved most satisfactory in a group of 34 patients.

Lukens1, reviewing the literature forty years ago, found 78 cases of traumatic enophthalmos and some nineteen hypotheses to explain its mechanism. Among the etiologic factors suggested were: (1) indirect fracture of the orbital walls, (2) direct fracture of the orbital walls, (3) injury to Muller's orbital muscle, (4) injury to the check ligaments, (5) rupture of Tenon's capsule, (6) atrophy of orbital tissue due to injury of the sympathetic or trigeminal nerves, (7) hemorrhage of the ophthalmic artery behind the ciliary body, (8) minute hemorrhages in the nerve sheaths, particularly of the sympathetic nerves, (9) cicatricial contraction of

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