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How much force is needed to damage an extraocular muscle?
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graymouse posted:
I ask because I had a minor clumsiness incident yesterday, accidentally jamming the side of my fingernail into the center of my lower eyelid, between the orbit and eyeball. (Elbow slipped while I was leaning my face on my hand, if you can believe it.) I could clearly feel a band of tissue in that space, and boy, did it hurt.

24 hours later and no visible changes, but the underside of my eye aches and feels swollen, especially when blinking or looking in any direction other than straight ahead.

Normally I wouldn't think anything of it, but this eye bulges out farther than the average person's due to chronically tense facial muscles (unresolved neck problem). I'm concerned that I may have hit the insertion point of a (probably already inflamed) extraocular muscle, but just haven't seen the effects yet. Is it likely that I hit the muscle with enough force to cause damage? How well do these muscles heal from minor trauma without intervention?
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Alan M Kozarsky, MD responded:
"the underside of my eye aches and feels swollen, especially when blinking or looking in any direction other than straight ahead"

If the discomfort has not resolved, it is time to see an ophthalmologist. Could be a corneal abrasion or other type of superficial bruise.
"but this eye bulges out farther than the average person's due to chronically tense facial muscles (unresolved neck problem)"
This is not a known reason for an eye bulging out; thyroid disorders and and eye socket tumors can cause this but not tense facial muscles.
"I'm concerned that I may have hit the insertion point of a (probably already inflamed) extraocular muscle"
There is no reason to believe that your extraocular muscles are inflamed. It would be very very unusual for you to damage your intraocular muscle with a finger or fingernail.
Bottom line, if discomfort or other symptoms persist, see an ophthalmologist. While there, ask if your eyes are really protruding and if so, find out the actual reason for the protrusion.


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