enophthalmos

Evidence of recession

Record the observation supporting true posterior displacement and the confidence assigned to it.

1. What examination or imaging evidence establishes posterior displacement within the orbit? definition
2. Which anatomical reference and comparison establish that the position is abnormal? measurement

Mimics and coexisting malposition

Document globe-size abnormalities, eyelid changes, comparison-eye abnormalities, and non-posterior displacement separately.

1. Could reduced globe size, eyelid position, or contralateral proptosis explain the apparent recession? boundary
2. Is any inferior or horizontal globe displacement present in addition to posterior recession? measurement

Instrument and landmark validity

Hertel measurements depend on lateral orbital rim integrity; record compromised landmarks. [Measurement limitations](https://www.ncbi.nlm.nih.gov/books/NBK563300/)

1. What were the readings for both eyes, instrument type, base setting where applicable, and observer? measurement
2. Have trauma, surgery, or anatomical asymmetry altered the landmarks used by this method? boundary

Comparator and threshold

Require an explicit comparator and justification for any diagnostic or change threshold, especially in bilateral cases.

1. Is interpretation based on the fellow eye, an earlier measurement, or a justified reference population? provenance
2. What supports the chosen threshold, and does the observed difference exceed uncertainty for this measurement method? measurement

Space, content, and retraction

Assess orbital cavity enlargement, soft-tissue volume loss, and fibrotic retraction as possible mechanisms. [Mechanism overview](https://www.ncbi.nlm.nih.gov/books/NBK563300/)

1. What evidence supports increased orbital space, reduced orbital contents, a retractile process, or a combination? provenance
2. Which orbital walls, fat compartments, or other tissues are implicated by the available examination or imaging? measurement

Supported causal link

Record evidence for a related injury, procedure, sinus disorder, or other condition without treating temporal association as proof.

1. Which preceding event or diagnosed condition is proposed to explain this eye's recession, and what supports that link? provenance
2. Which alternative causes remain unresolved, and what additional clinician-directed evaluation could distinguish them? action

Documented position trajectory

Keep reported onset, first documentation, and comparable serial measurements distinct.

1. When was recession first noticed, and what earlier photographs or examinations document baseline appearance or position? provenance
2. Do comparable observations support stability, progression, or improvement, and what limits that conclusion? measurement

Attributable burden

Separate observed impairment, reported distress, and the evidence connecting each to globe position.

1. Are diplopia, motility restriction, eyelid-closure difficulty, or visual changes documented, and what is their proposed relationship to the orbital abnormality? boundary
2. Which appearance changes or activity limitations matter to the person, and how are those concerns recorded over time? measurement

Next-step rationale

Record the responsible clinician's disposition and unresolved orbital or visual findings influencing it.

1. Are acute visual changes, trauma-related findings, or progressive unexplained recession present for clinician assessment of urgency? action
2. What supports observation, additional investigation, or specialist referral, and who owns the next step? action

Multidimensional outcome

Track globe position, associated impairment, personal concerns, and adverse effects separately after management.

1. What changed in measured recession and associated symptoms using comparable pre-management and follow-up observations? measurement
2. What residual displacement, new symptoms, or unmet personal priorities require reassessment? action

Check these first

Recalled without web access and unsourced; every item is a lead to verify.

1. Which of these check these first hold for the sense of enophthalmos this model covers, and on what evidence? provenance

Kinds and varieties

Recalled without web access and unsourced; every item is a lead to verify.

1. Which of these kinds and varieties hold for the sense of enophthalmos this model covers, and on what evidence? provenance

Identifiers and schemes

Recalled without web access and unsourced; every item is a lead to verify.

1. Which of these identifiers and schemes hold for the sense of enophthalmos this model covers, and on what evidence? provenance

Real-world use

Recalled without web access and unsourced; every item is a lead to verify.

1. Which of these real-world use hold for the sense of enophthalmos this model covers, and on what evidence? provenance

Typical measurements

Recalled without web access and unsourced; every item is a lead to verify.

1. Which of these typical measurements hold for the sense of enophthalmos this model covers, and on what evidence? provenance

Failure modes and hazards

Recalled without web access and unsourced; every item is a lead to verify.

1. Which of these failure modes and hazards hold for the sense of enophthalmos this model covers, and on what evidence? provenance

Neighbouring kinds and how to tell them apart

Recalled without web access and unsourced; every item is a lead to verify.

1. Which of these neighbouring kinds and how to tell them apart hold for the sense of enophthalmos this model covers, and on what evidence? provenance