Afferent examination included evaluation of visual acuity, afferent pupillary defect, decreased central vision, visual field, and the optic disc. Efferent function was determined by evaluating ductions, versions, and alignment. Adenexal structure and function were assessed by evaluating the function of cranial nerves V and VII, globe position, medial canthal tendon position, eyelid position and function (ptosis, lagophthalmos, eyelid retraction, and ectropion/entropion), chemosis, injection, and lacrimal outflow dysfunction. These examination findings were further categorized as functionally important or not. Corrective treatments, if necessary, were performed. Using the scale put forth by Imola and Schramm,7 we classified patients into categories based on functional ophthalmologic status: functional vision without impairment (no persistent sequelae); functional vision with impairment (1 or more postoperative sequelae treatable with ocular therapeutics); and nonfunctional vision (chronic ocular sequelae, blindness, exenteration, or impairments unresolved with ocular intervention).