Ruptured globe from spontaneous ethmoid-ocular fistula

Conjunctival-orbital fistula from extensive facial trauma

A 31-year-old man with a history of severe facial trauma and multiple reconstructive operations presented with a conjunctival-orbital fistula in the OS. Successful treatment required a vascularized orbicularis oculi flap with a temporalis fascia overlay. Risk factors for fistula formation included extensive orbital trauma, devascularized tissue from previous operations and infection, and prior strabismus surgery using the fornix-based approach.