Korean J Ophthalmol.  2008 Dec;22(4):255-258. 10.3341/kjo.2008.22.4.255.

Upper Eyelid Retraction After Periorbital Trauma

• Kwon SI
• Kim YJ

• KMID: 1084214
• DOI: http://doi.org/10.3341/kjo.2008.22.4.255

Abstract

We report four unusual cases of upper eyelid retraction following periorbital trauma. Four previously healthy patients were evaluated for unilateral upper eyelid retraction following periorbital trauma. A 31-year-old man (Case 1) and a 24-year-old man (Case 2) presented with left upper eyelid retraction which developed after blow-out fractures, a 44-year-old woman (Case 3) presented with left upper eyelid retraction secondary to a periorbital contusion that occurred one week prior, and a 56-year-old man (Case 4) presented with left upper eyelid retraction that developed 1 month after a lower canalicular laceration was sustained during a traffic accident. The authors performed a thyroid function test and orbital computed tomography (CT) in all cases. Thyroid function was normal in all patients, CT showed an adhesion of the superior rectus muscle and superior oblique muscle in the first case and diffuse thickening of the superior rectus muscle and levator complex in the third case. CT showed no specific findings in the second or fourth cases. Upper eyelid retraction due to superior complex adhesion can be considered one of the complications of periorbital trauma.

Keyword

Eyelid retraction; Periorbital contusion

MeSH Terms

Accidents, Traffic
Adult
Eye Injuries/*complications/surgery
Eyelid Diseases/*etiology/radiography
Female
Humans
Lacerations/complications/surgery
Lacrimal Apparatus/*injuries
Male
Middle Aged
Oculomotor Muscles
Orbital Fractures/*complications/surgery
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 Case 1: (A) At his visit he showed mild swelling and bruising in the left eyelid, but no retraction was noted. (B) Left upper eyelid retraction developed one month after blow-out fracture repair. (C) CT scan showing a large left medial and inferior wall fracture and soft tissue incarceration. (D) One month after blow-out fracture repair, this CT scan revealed adhesion between the superior rectus and superior oblique muscles (arrow).

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  Fig. 2 Case 2: (A) At his visit he showed swelling, bruising and retraction in the left eyelid. (B) Significant lid lag on downgaze in the left eye. (C, D) Eyelid retraction and lid lag persisted in the left eye one month after blow-out fracture repair.

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  Fig. 3 Case 3: (A) Left upper eyelid retraction with a 1 mm scleral show. (B) Significant lid lag on downgaze. (C) Contrast-enhanced CT scan showing mild and diffuse thickening between the superior rectus muscle and levator complex.

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  Fig. 4 Case 4: (A) Left upper eyelid retraction was observed one month after canalicular repair. (B) Significant lid lag on downgaze in the left eye. (C) Normal contrast-enhanced CT scan.

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