Progressive bilateral enophthalmos associated with cerebrospinal shunting.
A 22-year-old woman was examined for a complaint of bilateral progressive enophthalmos that had begun after the cerebrospinal fluid shunting procedure 9 years ago. Photographs and CT scans taken before surgery proved that the position of her eyes was normal before surgery. The enophthalmos was so severe that it induced a poor eyelid-globe apposition with trichiasis and superficial keratopathy. CT of the orbits showed that both orbital roofs were arched and displaced toward the anterior cranial fossa. The placement of porous polyethylene sheets on the orbital roofs through a coronal approach corrected the eye position. A literature review indicated that cerebrospinal shuntings are plagued by a variety of complications including bone changes and craniosynostosis. We believe that enophthalmos associated with cerebrospinal fluid shunting results from a rare acquired bony orbital anomaly.
Cruz
Antonio Augusto V
AA
Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil. aavecruz@fmrp.usp.br
Mesquita
Igor M O
IM
de Oliveira
Ricardo Santos
RS
D000328:Adult; D002557:Cerebrospinal Fluid Shunts / Q000009:adverse effects*; D018450:Disease Progression; D015841:Enophthalmos / Q000000981:diagnostic imaging / Q000209:etiology*; D005260:Female; D007839:Functional Laterality; D006801:Humans; D014057:Tomography, X-Ray Computed