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Old 07-03-2009, 09:29 PM   #1
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Join Date: May 2004
Location: Arlingtpn, VA
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wardnine HB User
Orbital fracture/double vision in right eye (very long)

Hello! In late May I got into a fight where I was hit and kicked a few times in the face. Had some double vision and redness in the eye immediately after so I got it checked out in an emergency room the next day and they said I had an orbital fracture which might be entrapping an eye muscle so they recommended I see an opthamologist.

That week I went to an opthamologist who looked at my eye and felt there was perhaps an entrapped muscle due to the fracture so he referred me to a plastic surgeon who specializes in facial and eyelid surgery (and also happened to be an opthamologist).

Went to see the plastic surgeon the next day who looked at the CT scan and ran some eye tests... he told me he didn't think the eye muscle was entrapped (because of the ways in which I could move my eye), but that the eye muscle (inferior rectus muscle) was weakened. He said that my double vision was something that generally wasn't permanent - that my inferior rectus would improve eventually but could take anywhere from a few weeks to months to fully heal as the muscle got stronger. He said I had a somewhat "sizable" orbital fracture but that I didn't really need surgery (just needed to wait for the muscle to heal), but that I should consider surgery for cosmetic reasons (he noticed my right eye had sunken back a bit and could continue to sink back over time). He also warned that if I had surgery, it would take my inferior rectus muscle even longer to heal. For that reason, I decided not to have surgery immediately but wanted to get another opinion.

I went to another plastic surgeon (who was not an opthamologist) a couple weeks later... he looked at the CT scan, did some eye tests and agreed that I had a good-sized orbital fracture. He felt as though the double vision "may" or "may not" get better over time if I had surgery (was basically unsure and warned it could be a bit worse after surgery) but felt I should consider surgery primarily for cosmetic reasons as he noticed my affected eye was a bit smaller than the other eye due to the sinking back of the eye.

I decided at that point to go ahead and have the surgery with the original plastic surgeon I saw. The surgery took place last week, roughly a month after the original injury. The doctor told me my surgery went very well despite the month-long wait. The double vision is slightly worse than it was before... the doctor said he expected that but that his prognosis for it hadn't changed... it should get a lot better as the inferior rectus muscle improves.

The other concern I had was, even a week after the surgery, my entire eye is still very red, puffy, and swollen and the stitches haven't fully absorbed yet (though I can see out of the eye perfectly). The doctor said not to worry about this - the red eye was due to swelling of the conjunctiva but would certainly go away within 2-3 weeks and that the eye is still recovering from the surgery. He again assured me that the double vision should improve as the eye muscle gets stronger. I was placed on prednisone and percocet to help with the recovery.

I guess my primary concern is with the double vision... the doctor seemed very optimistic that my vision will improve to normal (or very close to normal) eventually but I've also read about many cases where diplopia is permanent (though those cases weren't necessarily the same as mine). Is there something more I could do to help it improve or should I just wait for it to heal as the doctor says it will?

The other concern is that my eye still looks like I just had surgery yesterday (red, puffy, and swollen... very small amounts of blood still leak from it on occasion)... the doctor told me not to worry about it and there isn't much soreness and I can see out of the eye perfectly fine but it just seems odd to me that it still looks this way a week after surgery. Is this another thing where I should be patient and wait for it to improve? Have a follow-up appointment in a couple of weeks but just wondering if I should do anything between now and then (besides rest).

Any advice is appreciated and I appreciate anyone who took the time to read the post... just concerned about my eye getting better, thanks!!!

 
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