Orbital emphysema

Orbital emphysema (/ˈɔː(r)bɪt(ə)l ˌemfɪˈsiːmə/, also known as pneumo-orbit) is a medical condition that refers to the trapping of air within the loose subcutaneous around the orbit that is generally characterized by sudden onset swelling and bruising at the impacted eye, with or without deterioration of vision, which the severity depends on the density of air trapped under the orbital soft tissue spaces. It is most commonly result from forceful sneezing, nose blowing, or coughing among patients with a history of periorbital trauma or orbital fractures that happened several hours-days in advance. Rare occasions have also been reported in relation to individuals with no traumatic past events that include: infection, esophageal rupture, postoperative complications, pulmonary barotrauma, with the same predisposing factors (sneezing, nose blowing, or coughing). A four-stage system of orbital emphysema was developed for severity classification. Clinical diagnosis can be made based on a combination of medical history, physical examination, and computed tomography. There are three kinds of orbital emphysema including palpebral emphysema, true orbital emphysema, and orbitopalpebral emphysema. Orbital emphysema on its own is a mild and self-limiting disease, and usually requires no treatment. If related visual symptoms or other acute orbital compression symptoms are present, lateral canthotomy or cantholysis, orbital decompression by needle aspiration, and bone decompression may be required to relieve orbital pressure and preserve vision.