Transactions . les, those which are caused by cicatricial bands and adhesiveinflammation after operative interference in the orbit, thosewhich followed extirpation of a tumor involving the cervicalsympathetic ^ and, finally, those in which there is a monolateral,non-traumatic enophthalmos changing into exophthalmos whenthe head is bent forward — such cases, for example, as havebeen reported by Robert Sattler, Gessner, and others. Transactions of the Philadelphia County Medical Society, February, iSgo. - Archives of Ophthalmology, Vol. XXII, p. g8. ^ Klin. Monatsbl. f. Augenheilk., September, 1
Transactions . les, those which are caused by cicatricial bands and adhesiveinflammation after operative interference in the orbit, thosewhich followed extirpation of a tumor involving the cervicalsympathetic ^ and, finally, those in which there is a monolateral,non-traumatic enophthalmos changing into exophthalmos whenthe head is bent forward — such cases, for example, as havebeen reported by Robert Sattler, Gessner, and others. Transactions of the Philadelphia County Medical Society, February, iSgo. - Archives of Ophthalmology, Vol. XXII, p. g8. ^ Klin. Monatsbl. f. Augenheilk., September, 1893. ?* Ophthalmic Review, May, 1894. * Loc. cit. See Shapringer, loc. cit., and Centralbl. f. prakt. Augenheilk., Vol. XIII, p. igi. Del Monte: Osservazione e note Cliniche, 1S71, p. 71; and Litteneuer; Gaz. des Hopitaux, 1873, I, p. 243. Matlakowski: Centralbl. f. prakt. Augenheilk., 18S1, XV, p. 387.^ Amer. Journ. Med. Sc, 1885, n. s., 89, p. ; Centralbl. f. prakt. Augenheilk., 1S89, XIII, p. Fi.;. 2. DE ScHWEiNiTZ : Traiimatic Enophthahnos, with a Case. 389 The various theories which have been advanced to explainthis condition may be summarized as follows : 1. Cicatricial contraction of the retrobulbar connectivetissue following periostitis and inflammation (Gessner) ; or cica-tricial adhesions of the eyeball itself (Low). 2. Atrophy of the orbital cellular tissue on account of adisturbance of nutrition due to a lesion of a nerve center ortract, and particularly of the sympathetic, or of the trigeminus.(Beers theory.) 3. Paralysis of Miillers orbital muscle from lesion of thesympathetic (Schapringer). 4. Fracture of the orbital walls (inner or under) causing en-largement of the orbital space and allowing retraction or sinkingof the eyeball (Langenbeck, Tweedy, \on Becker, Lang, etc.). Schapringer contends, and, no doubt, with good reason, thatthe name enophthalmos should be retained for those cases inwhich the retraction of the eyeball occurs indirectly from
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