|ECR 2019 / C-1048|
|The sunken eye: An educational review of imaging findings in enophthalmos|
Enophthalmos, as measured on CT and MRI on the axial plane, is defined as asymmetric posterior displacement of the globe of at least 2 mm of the affected side. Specifically, the displacement on the axial plane must be measured at the interzygomatic line where a transversely oriented imaginary line is drawn from one bony zygomatic arch to the other (Fig. 1). The radiographic measurements for bilateral enophthalmos are still debated in the literature. However, ophthalmologic exam defines enophthalmos, unilateral or bilateral, as exophthalmometric values of less than 14 mm. Exophthalmometry is an instrument used to measure displacement of the globes both on a relative and absolute scale. Although enophthalmos most commonly follows traumatic facial injuries, in the absence of trauma it can be concerning for an underlying systemic disease. Clinically, patients with enophthalmos can present with diplopia, ptosis, and apparent contralateral exophthalmos. In this educational exhibit, we highlight the many CT and MRI manifestations of this condition.