Bony Socket

Shelving of Lower fornix

Lower fornix shelving or obliteration is one of the most common way to encounter contracted socket. It is because of neglected sockets or ill fitted prosthesis usage. In mild shelving lower fornix deepening sutures suffices and in worse cases surgical reconstruction of lower fornix becomes mandatory enable to fit the prosthesis which usually need mucous membrane grafting. 

Contracted Socket

In my opinion this part is a real challenge to Oculoplastic Surgeon. This varies from simple fornix deepening suture to mucous membrane graft to dermis fat graft to temporalis flap and much more including socket expansion. In unrepairable sockets spectacle mounted prosthesis is the last option.

Ill- fitted ocular prosthesis

The use of ill fitting prosthesis must be discouraged as they destroy the socket more and surgical reconstructed subsequently becomes much difficult and also over all results deteriorate.  

Reduced orbital fat

Lipofilling or lipoinjection is a procedure being carried out to get back orbital fat. Retrobulbar injectionof fat in seeing eye should not be encouraged and to give volume in anterior orbit can safely be done with good patients satisfaction.