Because we are board certified Ophthalmologists trained and certified in ophthalmic plastic and reconstructive surgery, we are the ONLY specialty uniquely qualified to evaluate and reconstruct the eye, eyelids, eye socket and surrounding structures after trauma. Dr. Gilliland is uniquely qualified to treat orbital trauma and trauma from sports related injuries. He has been the team physician for the NHL DALLAS STARS and consulted on numerous athletes from other professional teams including the NBA MAVERICKS, the NFL DALLAS COWBOYS, the MLB TEXAS RANGERS and the PBR (professional bull riders). In addition, he has worked with a craniofacial surgery team for over 20 years.
Trauma to the eye, eyelids, orbit and facial bones can occur due to a myriad of causes. Not uncommonly, motor vehicle accidents are the cause in many patients. Penetrating trauma to the periocular structures can be due to bullet wounds, stab wounds, arrow wounds and many other sharp and blunt objects. Trauma to the periocular structures is not uncommonly associated with injury to the eye, facial bones, brain, chest and abdomen.
The soft tissues of the eyelids are easily damaged in many trauma patients. It is not uncommon for the lacrimal gland which lies under the upper outer eyelid to be injured. In addition, the muscles which open and close the eyelid, the tarsal plate (a collagenous structure which provides a framework for the eyelid), the tear drainage system and the extraocular muscles can be easily damaged. Repair of these injuries is achieved anatomically and is individualized to the patient.
The bones of the orbit (eye socket) are not infrequently broken with blunt or penetrating trauma to the head and face. The thinnest bones in the face are the floor and medial wall of the orbit. When fractured, these bones can “trap” the soft tissue in the orbit and cause double vision, a sunken appearance to the eye and numbness to the cheek. More severe trauma can fracture the bones of the forehead and cheek which can impair visual function and cause loss of vision, double vision and painful movements of the eye. It is common to wait several days from the time of injury to repair to allow soft tissue swelling to resolve.
Surgery is typically done with an overnight stay in the hospital. We utilize the latest technology including image guided surgery to make the procedures safe and effective.
Patients typically experience little discomfort with orbital fracture repair. It is not unusual to have some swelling which can cause temporary double vision and even swelling of the eyeball which is called chemosis. These are typically self limiting.
Complications are rare. The most devastating complication is loss of vision but this is fortunately exceedingly rare. It is not unusual to have temporary double vision. Less than 5% of patients have double vision that does not resolve without strabismus surgery. This is typically related to the mechanism of injury and not the surgery.