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DOI: 10.1055/s-0039-1688945
The Degree of Posttraumatic Enophthalmos Detectable by Lay Observers
Publication History
Publication Date:
17 May 2019 (online)

Abstract
This study was to determine the degree of posttraumatic enophthalmos that is detectable by lay observers. In this case-control study, 60 photographs (frontal and oblique angles) of patients from an oculoplastics registry at the authors' institution were reviewed by lay observers. Patients were included if they had between 1 and 5 mm of unilateral enophthalmos, at least 6 months following trauma. They were divided into five groups of 10 and each group was separated by increments of 1 mm. Controls were selected from the same database and had 0 mm difference between each eye. Patients were excluded if they had any medical condition that might cause enophthalmos (including use of prostaglandin analogues). Participants were also excluded if they had any medical or surgical condition affecting the contralateral side. Lay observers were randomly selected from a pool of volunteers in nonmedical programs at our affiliated university. The primary outcome measure was the asymmetry cut-off (in millimeters) in which more than 50% of the cases (chance) were identified correctly. The generalized mixed model predicts that 66% of lay observers would correctly identify a difference between both eyes at a rate greater than would be predicted by chance, if at least a 5 mm difference existed between them (95% confidence interval [CI] 55.5–75%). This study shows that lay observers only reliably detect unilateral enophthalmos when there is at least a 5 mm difference between the eyes. This study used two-dimensional (2D) photographs and, therefore, results with three-dimensional (3D) observation may be different. In this study of 2D photographs, unilateral posttraumatic enophthalmos is only reliably detected by lay observers when a 5 mm difference exists between the eyes.
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References
- 1 Cline RA, Rootman J. Enophthalmos: a clinical review. Ophthalmology 1984; 91 (03) 229-237
- 2 Smith RJ, Balbo NS, Lahoz Ibaceta MJ. [Enophthalmos secondary to an orbital varix]. Medicina (B Aires) 2014; 74 (02) 127-129
- 3 Kirkali PA, Kansu T, Sanac AS. Unilateral enophthalmos in systemic scleroderma. J Clin Neuroophthalmol 1991; 11 (01) 43-44
- 4 Hobbs CGL, Saunders MW, Potts MJ. Spontaneous enophthalmos: silent sinus syndrome. J Laryngol Otol 2004; 118 (04) 310-312
- 5 Peplinski LS, Albiani Smith K. Deepening of lid sulcus from topical bimatoprost therapy. Optom Vis Sci 2004; 81 (08) 574-577
- 6 Shields CL, Stopyra GA, Marr BP, Moster ML, Shields JA. Enophthalmos as initial manifestation of occult, mammogram-negative carcinoma of the breast. Ophthalmic Surg Lasers Imaging 2004; 35 (01) 56-57
- 7 Yip CC, Gonzalez-Candial M, Jain A, Goldberg RA, McCann JD. Lagophthalmos in enophthalmic eyes. Br J Ophthalmol 2005; 89 (06) 676-678
- 8 Rubin PAD, Rumelt S. Functional indications for enophthalmos repair. Ophthal Plast Reconstr Surg 1999; 15 (04) 284-292
- 9 Dulley B, Fells P. Long-term follow-up of orbital blow-out fractures with and without surgery. Mod Probl Ophthalmol 1975; 14: 467-470
- 10 Putterman AM, Stevens T, Urist MJ. Nonsurgical management of blow-out fractures of the orbital floor. Am J Ophthalmol 1974; 77 (02) 232-239
- 11 Wilkins RB, Havins WE. Current treatment of blow-out fractures. Ophthalmology 1982; 89 (05) 464-466
- 12 Koo L, Hatton MP, Rubin PAD. When is enophthalmos “significant”?. Ophthal Plast Reconstr Surg 2006; 22 (04) 274-277
- 13 Christensen BJ, Zaid W. Inaugural survey on practice patterns of orbital floor fractures for American oral and maxillofacial surgeons. J Oral Maxillofac Surg 2016; 74 (01) 105-122
- 14 Liu EH, Najarali Z, Farrokhyar F, Banfield L, McRae M. Resolution of diplopia in late repair of enophthalmos following facial trauma. J Craniofac Surg 2018; 29 (04) 1006-1011
- 15 Han F, Zhu S-C. Bayesian reconstruction of 3D shapes and scenes from a single image. Available at: http://lear.inrialpes.fr/people/triggs/events/iccv03/cdrom/hlk03/han.pdf . Accessed February 4, 2019
- 16 Hassner T, Basri R. Example based 3D reconstruction from single 2D images. Available at: http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.421.2529&rep=rep1&type=pdf . Accessed February 4, 2019