Enophthalmos

Classification according to ICD-10
H05.4	Enophthalmos
ICD-10 online (WHO version 2019)

An enophthalmos ( ophthalmos , Greek: "eyeball") is the sinking of the eyeball into the eye socket ( orbit ). Colloquially, it is described as sunken eyes . This is a symptom that can have a variety of causes:

1. Sympathetic paralysis : If the head part of the sympathetic is damaged, the orbital muscle ( smooth muscles in the periorbita ) fails . The tone of this muscle usually ensures that the periorbita is taut and the eye is pushed forward, i.e. slightly out of the eye socket. If it fails, mild enophthalmos occurs, which is one of the signs of Horner's syndrome .
2. Emaciation : With severe emaciation ( cachexia ), the fatty tissue behind the eyeball is also broken down. This retrobulbar fat body stabilizes the normal eye position in the orbit.
3. Loss of fluid : In the event of severe blood loss, very low blood pressure or other fluid losses (e.g. severe diarrhea ), the eyeball will sink in, as the venous plexus ( plexus ophthalmicus ) behind the eye is also important for its position.
4. Muscle cramps : General cramped states of the muscles (e.g. tetanus ) lead to simultaneous contractions of the outer straight muscles of the eye ( muscles recti , musculus retractor bulbi ), which then pull the eye back into the orbit.
5. Fractures : If the orbital bone structure breaks ( e.g. orbital floor fracture ), the eye can also sink in.
6. Eyes drilling ( Okulodigitales phenomenon ): In this stereotypical behavior to drill blind children in the eyes to so-called entopische phenomena perceive (like lightning). Constant pressure on the eyes reduces the orbital fat and the eye sinks.
7. Stilling-Türk-Duane syndrome ( Duane syndrome ): This congenital ocular muscle paralysis (also known as congenital retraction syndrome) leads to a paradoxical coinnervation of the lateral rectus muscle . The muscle is not only innervated by the abducens nerve, but to a certain extent also by fibers of the oculomotor nerve , which at the same time innervate the medial rectus muscle . The result is a kind of restraining effect to which the eyeball is exposed when adduction is attempted . This usually triggers a retraction ( retraction ) of the eyeball. The disorder usually only occurs unilaterally.

In animals, enophthalmos is always associated with an incident of the nictitating membrane, which is only rudimentary in humans .

The opposite of enophthalmos is exophthalmos .

Individual evidence

1. ^ Revised diagnostic criteria for Marfan syndrome (Gent 1996) - Marfan Hilfe (Germany) eV In: marfan.de. Retrieved July 15, 2018 . 
2. ↑ Enophthalmus - Enophthalmie - Med-koM. In: Medizin-kompakt.de. Retrieved July 15, 2018 . 

This article is about a health issue. It is not used for self-diagnosis and does not replace a diagnosis by a doctor. Please note the information on health issues !