Orbital Decompression for the Treatment of Spontaneous Globe Luxations

Lumbreras-Fernández, Blanca; Sales‐Sanz, Marco; Contreras, Inés; Albandea, Ana Rosa

doi:10.3109/01676830.2015.1022661

Cited by 5 publications

(7 citation statements)

References 17 publications

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“…1 Though infrequently reported, exophthalmos secondary to orbital fat hypertrophy is also noted as a predisposing factor in obese patients. 7 SGL can be caused by non-traumatic eye manipulations, as in the case presented. It can also be caused by forceful Valsalva or eyelid maneuvering during contact lens insertion, as users push the eyelids past their natural threshold.…”

Section: Discussionmentioning

confidence: 69%

“…3,26 Obesity is an important risk factor that causes exophthalmos and is also associated in with FES in patients. 7,13,26 However, other reports have also shown that FES could occur in individuals with normal BMI. 27 In the case presented, the patient was African American and obese.…”

Section: Discussionmentioning

confidence: 99%

“…Lumbreras-Fernández et al reported the superiority of orbital decompression to tarsorrhaphy in managing patients with SGL and exophthalmos. 7 Luckily, most cases of SGL require no surgical intervention.…”

Section: Discussionmentioning

confidence: 99%

“…5,6 In one study, malar hypoplasia is reported as the most common predisposing factor for SGL. 7 In malar hypoplasia, the apex of the cornea is often present anterior to the malar prominence predisposing anterior globe luxation. In 2002, Kunesh and Katz described exophthalmos secondary to Graves' orbitopathy as the most common predisposing factor in globe luxation.…”

Section: Discussionmentioning

confidence: 99%

“…Following the reduction of the globe, treating the underlying condition and advising patients to lose weight may help prevent future subluxation. 3,7,25 If no reported risk factors or identi able triggering medical or psychiatric illnesses present, orbital imaging or serological studies for thyroid ophthalmopathy should be considered. Post-reduction outpatient follow up with an ophthalmologist and primary care provider can aid uncover the underlying etiology and predisposing factors.…”

Section: Discussionmentioning

confidence: 99%

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Spontaneous Globe Subluxation: A Case Report And Review Of The Literature

Yadete

Isby

Patel

et al. 2021

Preprint

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BackgroundSpontaneous globe subluxation (SGS) is an atraumatic anterior dislocation of the eyeball. It is exceedingly rare. Understanding SGS predisposing factors may help uncover its etiology and undertake vision-saving management.Case presentationA 48-year-old female presented to the ED with her right eye out of its socket. She reports blurry vision, photophobia, and pain in the affected eye. She was unable to close her right eyelid and was in obvious distress. On arrival, her blood pressure was elevated. Her medical history was notable for hypertension and obesity. On physical examination, extraocular eye movements were not intact, and the globe appeared whole and round. She was also unable to count fingers with the affected eye. There was no visible trauma to the face. Multiple wet gauzes with sterile saline were placed over the displaced eyeball. Direct and even pressure was applied on the globe. Within thirty seconds, the globe was reduced back in. The patient was able to close her eyelids and reports substantial pain relief with reduction. A CT scan of the orbits was then obtained, demonstrating mild bilateral proptosis. The globes were normal and symmetric. No intraconal or extraconal abscess or infection was seen. There were no intraconal or extraconal masses. There was no acute orbital traumatic injury, no avulsion of the optic nerve, ocular rupture, or retrobulbar hematoma. After reviewing the case with an ophthalmologist, a follow up appointment with the ophthalmologist was arranged. The patient was discharged on erythromycin ointment. Post-discharge investigation of the CT imaging revealed dilated optic nerve sheaths, tortuosity of the optic nerve, and empty sella. ConclusionsIn addition to causing distress and severe anxiety, SGS poses numerous immediate as well as long-term complications. Traction of the optic nerve and retinal vasculature may potentially cause retinal venous congestion and loss of visual acuity with potential vision loss. In the absence of known risk factors or disease processes, orbital imaging and serological studies for thyroid ophthalmopathy should be considered.

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Section: Discussionmentioning

confidence: 69%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Spontaneous Globe Subluxation: A Case Report And Review Of The Literature

Yadete

Isby

Patel

et al. 2021

Preprint

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Deep lateral rim-sparing orbital wall decompression in spontaneous globe subluxation associated with shallow orbits and eyelids laxity

Bengoa-González

Laslău

Martín-Clavijo

et al. 2019

Orbit

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Globe Subluxation After Proning in a Coronavirus Disease 2019 Patient

Karani

Valenzuela

Tran

et al. 2021

Ophthalmic Plastic &Amp; Reconstructive Surgery

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A 79-year-old male was hospitalized for respiratory failure secondary to coronavirus disease 2019 pneumonia. Approximately 6 hours after initiating proning, left globe subluxation with darkening of the superior sclera consistent with tache noir was noted. The left globe was thought to be hypotonus secondary to ciliary body shut down after a prolonged period of high intraocular pressure. The globe was reduced in the supine position with gentle traction of the eyelids. Over the next 24 hours, the left intraocular pressure improved to 10 mm Hg, and the tache-noir de la sclérotique resolved. The authors report the first known case of globe subluxation secondary to proning.

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Orbital Decompression for the Treatment of Spontaneous Globe Luxations

Abstract: Orbital decompression is an effective method for the prevention of new episodes in patients with spontaneous globe luxations. It has good aesthetic and functional results and addresses the exophthalmos present in most cases.

Cited by 5 publications

References 17 publications

Spontaneous Globe Subluxation: A Case Report And Review Of The Literature

Spontaneous Globe Subluxation: A Case Report And Review Of The Literature

Deep lateral rim-sparing orbital wall decompression in spontaneous globe subluxation associated with shallow orbits and eyelids laxity

Globe Subluxation After Proning in a Coronavirus Disease 2019 Patient

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