Orbital Fracture Surgery in Beverly Hills & Greater Los Angeles

An orbital fracture is a break in one or more of the thin bones that form the eye socket. Because these bones support the eye, its muscles, and the eyelids, a fracture can change how the eye moves, where it sits, and how the face looks. These injuries call for a highly specialized approach, and Dr. Kami Parsa treats orbital trauma for patients in Beverly Hills and across Los Angeles, from West Hollywood to Santa Monica, with the goal of restoring both function and facial balance.

Dr. Parsa’s approach to eye and eyelid trauma is grounded in the clinical literature he helped write. He coauthored the chapter on closed globe injuries and eyelid lacerations in Ocular Trauma, a clinical textbook published by Elsevier Saunders, and he lectures on innovations in complex orbital reconstruction and custom implants for facial and orbital reconstruction. During his two-year fellowship in oculoplastic and reconstructive surgery at the University of Miami’s Bascom Palmer Eye Institute, he took part in research on developing customized facial implants for reconstruction. Today he is an Adjunct Clinical Professor at the Keck School of Medicine of USC and is affiliated with Cedars-Sinai Medical Center and Los Angeles General Medical Center, formerly LAC+USC Medical Center.

“An orbital fracture is never just a broken bone. I look at how the eye moves, where it sits, and how the eyelids will heal, because a good repair has to restore all three.” — Dr. Kami Parsa

Understanding Orbital Fractures and Their Causes

Most orbital fractures in Los Angeles come from car accidents, sports injuries, falls, and assaults. When something larger than the eye socket opening strikes the face, such as a fist, a ball, or a dashboard, the force can travel into the orbit and break its thinnest walls. Many of these injuries are not obvious from the outside, which is why imaging and a specialist evaluation matter. Orbital fractures generally fall into a few categories:

• Orbital floor fractures: Often called blowout fractures, these break the thin bone beneath the eye and can trap tissue or allow the eye to sink over time.
• Medial wall fractures: The inner wall of the socket, next to the nose, is very thin and often breaks along with the floor.
• Orbital rim fractures: The thick outer edge of the socket usually breaks only with higher energy impacts and may involve other facial bones.
• Cheekbone fractures: Known as zygomaticomaxillary complex fractures, these involve the cheekbone along with the side and floor of the socket and may be managed together with other facial trauma specialists.
• Trapdoor fractures in children: A child’s flexible bone can crack and snap back into place, pinching an eye muscle. The eye may look almost normal from the outside, yet the injury needs urgent attention.

Orbital Fracture Symptoms to Watch For

Symptoms can range from subtle to severe, and some appear only after swelling begins to settle. Common signs include:

• Double vision, especially when looking up or down
• Pain when moving the eye
• An eye that looks sunken or sits lower than the other, called enophthalmos
• Swelling and bruising around the eye
• Numbness of the cheek, upper lip, upper teeth, or side of the nose
• Swelling that suddenly increases after blowing the nose

When an Orbital Injury Is an Emergency

Some eye injuries cannot wait for an office visit. Call 911 or go to the nearest emergency room right away if you or your child has vision loss or blurred vision that does not clear, severe eye pain, an eye that is bulging forward, blood inside the front of the eye, a cut through the eyelid or eye, or signs of a head injury such as confusion or loss of consciousness. Nausea, vomiting, a slow heart rate, or fainting when the eye moves can signal a trapped eye muscle, particularly in children, and this also requires emergency care. Until you have been evaluated, avoid blowing your nose, since this can force air into the tissues around the eye. Once emergency concerns have been addressed, a follow-up evaluation with an oculoplastic surgeon helps determine whether the fracture needs repair.

Expert Evaluation and Surgical Planning for Orbital Fractures

An injury strong enough to break the orbit can also injure the eye itself, so Dr. Parsa’s evaluation begins with a complete eye examination. He checks vision, eye pressure, pupil response, eye movement, the position of each eye, and sensation in the cheek and lip. A CT scan of the orbits shows the exact location and size of the fracture and whether muscle or soft tissue is caught in the break.

Timing is one of the most important parts of planning:

• Trapped muscle: A fracture that traps an eye muscle, especially in a child, is usually repaired urgently, often within a day or two.
• Large fractures: Fractures large enough to cause a sunken eye or lasting double vision are commonly repaired within about two weeks, once swelling has eased enough to allow an accurate assessment.
• Small, stable fractures: Many small fractures heal well without surgery. Double vision caused by swelling often improves on its own, so Dr. Parsa may recommend close monitoring before making a surgical decision.

Orbital Fracture Repair With Hidden Incisions

When surgery is recommended, Dr. Parsa typically works through incisions placed on the inside of the lower eyelid, within the natural upper eyelid crease, or at the inner corner of the eye, depending on which walls are involved. Through these openings he frees any trapped muscle or tissue, returns the contents of the socket to their proper position, and rebuilds the broken wall with a thin implant shaped to the patient’s anatomy.

Because lower eyelid approaches can affect how the eyelid heals, he pays close attention to eyelid support throughout the repair. This reduces the risk of problems such as eyelid retraction or an outward turning eyelid that would call for ectropion repair. Injuries that involve the cheekbone or several facial bones may be coordinated with other facial trauma specialists. Patients receive medically necessary care along with the kind of attention to symmetry and detail usually associated with cosmetic surgery.

What to Expect After Orbital Fracture Surgery

Orbital fracture surgery is usually performed under general anesthesia at an accredited surgical facility in Beverly Hills, and most patients return home the same day. Swelling and bruising are most noticeable during the first one to two weeks. Cold compresses, sleeping with the head elevated, and avoiding nose blowing and heavy straining for the period Dr. Parsa recommends all support healing.

Many patients return to work and social activities within about two weeks. Double vision and numbness can take weeks to months to improve, and in some cases they do not resolve completely. As with any surgery, risks include bleeding, infection, persistent or new double vision, lasting numbness, changes in eyelid position, and in rare cases vision loss. Dr. Parsa reviews these risks with each patient and follows healing closely at scheduled visits. Patients who notice a sunken eye or eyelid changes months or years after an earlier repair may also benefit from revisional eyelid surgery.

Why Patients Choose Dr. Parsa for Orbital Fracture Repair

Recovering from facial trauma involves more than closing an incision. Patients and referring physicians choose Dr. Parsa for the depth of his reconstructive experience and his attention to how the eye and eyelids function and look after healing.

• Exclusive Focus on the Eyelids and Orbit: Dr. Parsa’s practice is devoted to reconstructive, revisional, and cosmetic surgery of the eyelids and surrounding tissues, with no general plastic surgery.
• More Than 20 Years of Clinical Experience: He has cared for patients with eyelid and orbital conditions for more than two decades in Beverly Hills.
• Pediatric Craniofacial Team Member: As a member of the Cedars-Sinai Medical Center Pediatric Craniofacial Surgery Team, he brings added perspective to facial injuries in children.
• Revision as a Clinical Focus: Revisional eyelid surgery is central to his practice, which helps when an eyelid needs correction after trauma or a previous repair.
• Surgical Education Leadership: He cofounded Surgery Theater Inc. and served as its CEO from 2009 to 2019, sharing surgical video education with physicians.
• Humanitarian Reconstructive Care: He founded the Surgical Friends Foundation, which provides reconstructive surgery to patients without access to quality medical care.

Schedule an Orbital Fracture Consultation in Beverly Hills

If you have had a facial injury and are noticing double vision, a sunken eye, or numbness around the cheek, early evaluation gives you the widest range of treatment options. Dr. Kami Parsa sees patients at his office at 465 N Roxbury Dr, Suite 1011, in Beverly Hills and welcomes patients from across Los Angeles. Schedule a confidential consultation to learn whether observation or surgical repair is right for you. If you have any of the emergency warning signs described above, please go to the nearest emergency room first.

Frequently Asked Questions About Orbital Fractures

• What are the most common causes of orbital fractures in the LA area?
• Is surgery always necessary for orbital fractures?
• How soon should I see a specialist after facial trauma?
• Where is orbital fracture surgery performed?
• Will I have a visible scar?