Silent Brain Syndrome refers to progressive bilateral enophthalmos in patients with a history of early ventriculo-peritoneal shunting (VPS) for hydrocephalus.
Enophthalmos examination: the chin-up position, also known as the dog's eye view, worm's eye view or lover's view is the best way to examine for enophthalmos or proptosis. The left proptosis in this patient makes the right eye look enophthalmic.
If you have exophthalmos, there's also a small risk of the optic nerve (which transmits signals from the eye to the brain) becoming compressed. This may affect your sight permanently if it isn't treated quickly.
Medical Care. Medical treatments in patients with enophthalmos are directed at specific diseases and may include chemotherapy or ionizing radiation for metastatic disease or immunosuppressive treatments for inflammatory disorders.
Silent sinus syndrome occurs due to hypoventilation of the maxillary sinus after osteomeatal complex obstruction.
As the acute swelling resolves, double vision will generally either stay the same or improve, while the enophthalmos will either remain the same or worsen. Thus while diplopia may be an initial concern immediately after the injury, it often resolves over time on its own without surgical intervention.
Successful repair of late enophthalmos has been demonstrated in multiple recent studies and is likely related to the precision with which orbital anatomy can be restored.
There are two phases of Thyroid Eye Disease. The first phase is called the acute phase, or active phase when symptoms are apparent. The second is called the chronic phase, or the inactive phase when there are few or no symptoms.
Migraines and tension headaches
Tension and migraine headaches are two types of headaches that can induce a sense of pressure behind the eyes. Tension headaches are the most frequent type of headache, with over 80% of people suffering from them.
The main complications from progressive enophthalmos include: Corneal complications such as dry eye syndrome, exposure keratopathy, infectious keratitis, increased epiphora and decreased visual acuity from poor lid apposition.
Enophthalmos is the recession of a normal sized globe into the orbit. There is associated elevation of the third eyelid and variable narrowing of the palpebral fissure. Retraction of the globe as a result of pain is a common cause.
ptosis (drooping of the upper eyelid) anhidrosis (decreased sweating) miosis (constriction of the pupil) Enophthalmos (sinking of the eyeball into the face)
Sunken eyes are eyes that appear dark or hollow. Possible causes include aging, sleep loss, dehydration, and trauma. Depending on the cause, medication and home remedies may help. The skin under the eyes is delicate, which is why it sometimes appears sunken and has darker coloring than elsewhere on the face.
Horner syndrome (Horner's syndrome or oculosympathetic paresis) results from an interruption of the sympathetic nerve supply to the eye and is characterized by the classic triad of miosis (ie, constricted pupil), partial ptosis, and loss of hemifacial sweating (ie, anhidrosis), as well as enophthalmos (sinking of the ...
Traumatic enophthalmos, either following orbital floor fracture or enucleation, is caused by decreased orbital volume. Volume replacement, both surgical and/or nonsurgical, provides a direct treatment.
Early symptoms of thyroid eye disease are itching, watering or dry eyes and a feeling of grittiness of the eyes. Some people may notice a swelling around the eyelids and sometimes the front of the eye becomes swollen.
Silent sinus syndrome can cause facial asymmetry (usually without pain), and vision problems (such as diplopia and enophthalmos). It may also cause headaches, and a feeling of fullness in the nose.
Even if patients are asymptomatic, any clinical suspicion should prompt referral to an otolaryngologist for comprehensive evaluation, including nasal examination. Septal deviation is common in patients with SSS, and typically deviates to the ipsilateral side of disease.
The definitive treatment for silent sinus syndrome is surgical, and otolaryngological consultation may be necessary. The blockage of the ostiomeatal complex (Fig. 2B) must be relieved by functional endoscopic sinus surgery. Typically, endoscopic uncinectomy and opening of the maxillary sinus ostium are done.
Reconstruction of the orbit must be performed to prevent enophthalmos and to preserve normal orbital volume. Markowitz and colleagues55 note that primary bone grafts to the medial and inferior orbital wall are “almost always” indicated.
Rather, entrapment occurs when any orbital tissue is trapped due to the septa coursing the orbit and in intimate relation to the IR (Fig 1). Patients with entrapment may have painful supraduction, nausea/vomiting, or oculocardiac reflex signs such as bradycardia.
The surgery was successful in ten of 17 cases (58.8%), and the success rate was higher in patients who were treated early (77.8% vs. 37.5%), but the difference was not statistically significant (p=0.092) (Fig. 5). The age of the patients did not affect the surgical outcome (p=0.077).