Eyeball Displacement into Ethmoid Sinus with Good Visual Restoration

Hye Rim Choe; Namju Kim; Ho-Kyung Choung

doi:10.3341/jkos.2016.57.9.1472

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Choe, Kim, and Choung: Eyeball Displacement into Ethmoid Sinus with Good Visual Restoration

Case Report

J Korean Ophthalmol Soc 2016;57(9):1472-1475.

Published online: 25 September 2016

DOI: https://doi.org/10.3341/jkos.2016.57.9.1472

Eyeball Displacement into Ethmoid Sinus with Good Visual Restoration

Hye Rim Choe, MD^1,², Namju Kim, MD^1,², Ho-Kyung Choung, MD^1,³

¹Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea

²Department of Ophthalmology, Seoul National University Bundang Hospital, Seongnam, Korea

³Department of Ophthalmology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea

Address reprint requests to Namju Kim, MD Department of Ophthalmology, Seoul National University Bundang Hospital, #82 Gumi-ro 173beon-gil, Bundang-gu, Seongnam 13620, Korea Tel: 82-31-787-7376, Fax: 82-31-787-4020 E-mail: resourceful@hanmail.net

Received 16 June 2016 Revised 15 July 2016 Accepted 19 August 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To report a case of eyeball displacement into the ethmoid sinus followed by early surgical intervention and good visual recovery.

Case summary

A 46-year-old female visited our hospital after she injured the right side of her face. Her visual acuity could not be measured and computed tomography revealed displacement of the right eyeball into the ethmoid sinus, as well as right medial orbital wall fracture and rupture of the right medial rectus muscle. She underwent surgical reduction of the herniated eyeball and surgical correction of the medial orbital wall fracture within 20 hours after the accident. Eighteen months after the surgery, visual acuity of the right eye improved from light perception to 20/28, and her color vision and visual field of the right eye improved to normal range.

Conclusions

Displacement of the eyeball in the orbital wall fracture is very rare, and eyeball displacement into the ethmoid sinus is even rarer. We achieved good visual outcome through early surgical intervention. The early anatomical reduction of the displacement and wall fracture may promote improved final visual outcome in other similar cases.

Keywords: Ethmoid sinus, Eyeball displacement, Medial rectus muscle rupture, Orbital wall fracture

References

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Figure 1.

Eyelid photo of the patient. Eyeball could not be found in the palpebral fissure and only conjunctiva was found.

Figure 2.

Computed tomography (CT) of the patient. Coronal (A) and axial (B) CT scans showed the medial orbital wall fracture in her right side and the herniated globe (arrow) into the ethmoid sinus.

Figure 3.

Eyelid photo of the patient 18 months after the eyeball reduction and strabismus surgery. There was only 18 prism diopters of exotropia of the right eye in the primary gaze, despite of the previous rupture of her right medial rectus muscle.

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