Unilateral facial atrophy and orbital fat loss in Parry-Romberg syndrome

Abstract

An 80-year-old woman presented at the Truhlsen Eye Institute for evaluation of left upper eyelid ptosis. The left eye was enophthalmic by 6.5 mm (A). Additional history revealed progressive facial asymmetry over a 60-year period. Computed tomography revealed striking left orbital volume deficit, with near complete absence of orbital fat, with crowding of orbital structures (B-D). The patient was diagnosed with Parry-Romberg syndrome, consistent with a history of noncongenital, progressive left facial atrophy and imaging findings. She elected to undergo orbital wedge implantation to improve orbital volume; however, the procedure did not sufficiently improve her enophthalmos.