Diplopia secondary to orbital surgery

Diplopia may occur following any type of ocular or pericocular surgery. The surgeries most frequently associated with postoperative diplopia include: repair of orbital fracture, endoscopic sinus surgery (from inadvertent orbital penetration), and orbital decompression for thyroid-related immune orbitopathy (TRIO). Postoperative diplopia after orbital tumor resection has been reported--e.g., after excision of fibrous dysplasia and osteoma. However, a recent case series suggests diplopia after orbital tumor resection is uncommon and transient. Surgical intervention for orbital trauma carries the highest risk of postoperative diplopia and will be the focus of this review. We will also present a case report of worsening diplopia following repair of orbital floor fracture to highlight potential motility issues that can arise when implants are employed to treat orbital floor fractures.