Relationship of the eye to the bony orbit, with clinical correlations.

Abstract

To examine normal anatomic relationship of the globe to the bony orbit, and relate variations in this relationship to clinical parameters. Seventy-nine axial and sagittal magnetic resonance imaging (MRI) scans of the globe and orbit were studied. Any patients with pathology, as reported by the radiologists' findings, were excluded. Measurements were made on the images to determine the position of the globe relative to the bony orbit and to describe the configuration of the anterior face of the maxillary sinus. Clinical measurements were performed on photographs of 36 patients who underwent MRI scans. An independent observer rated these photographs for two clinical findings: inferior scleral show and tear trough deformity. Correlations were found in the following sets of variables. (i) Corneal projection from infraorbital rim and corneal projection from lateral rim; (ii) corneal projection from supraorbital rim and corneal projection from lateral rim; (iii) scleral show and corneal projection from lateral orbital rim; and (iv) tear trough deformity rating and angle of anterior face of maxillary sinus. There were no significant correlations found in the other data variables. The data show that abnormal relationships between the globe and the bony orbit can have clinical consequences. Inferior scleral show is shown to be related to relative globe prominence, measured from either the lateral or the inferior orbital rims. The tear trough deformity is correlated with a sloping maxillary face. The results provide a rational basis for surgeries designed to normalize these relationships.