Periorbital Emphysema Following Ocular Trauma
Photographer: Audrey C. Ko, MD
Posted July 31, 2018
A 25-year-old man presented to the University of Iowa Hospitals and Clinics with an asymptomatic right medial orbital wall fracture without signs of entrapment or retrobulbar hemorrhage. Examination was remarkable for crepitus when palpating the inferior orbital rim. In patients with a history of facial trauma, surgery, or sinusitis, air can travel through the damaged sinus and become trapped in the subcutaneous tissues in and/or surrounding the orbit. It is typically a self-limiting condition with spontaneous recovery in two to three weeks . However, if a large amount of air becomes entrapped within the orbit, vision loss can occur secondary to optic nerve compression leading to ischemic optic neuropathy. Drainage of the trapped air in the subcutaneous tissue may be considered if there are signs of orbital compartment syndrome threatening vision .
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