Orbital emphysema is where air collects within the eyelid or orbit, the space within the skull that contains the eyeball. This may increase pressure within the eye and result in vision loss.
The condition is
While most cases require no treatment, removing the trapped air is sometimes necessary to avoid permanent vision loss.
Keep reading to learn about orbital emphysema, including its types, causes, symptoms, diagnosis, and treatments.
- Palpebral: This refers to cases where the air is in the eyelid only and not within the orbit.
- Orbital: This refers to the appearance of air behind an intact orbital septum, the thin membrane that lies between the eyelid and orbit. It occurs after a fracture of the orbital bone or a tear in the mucous membrane that lines the nasal cavity.
- Orbitalpalpebral: This occurs when pressure from air in the orbit overcomes the mechanical barrier of the orbital septum, leading to air passing from the orbit to the eyelid.
The above 2019 case report suggests that trauma is the most common cause of injured tissues and fractures. However, it also explains that nontraumatic factors may be responsible. These include:
- nose blowing
Other nontraumatic causes include:
- dental procedures
- ear and throat procedures
- infections from gas-producing microorganisms
Additionally, orbital emphysema can occur after eye surgery.
- pain in the orbit
- restriction of eye movements
- hypoesthesia, a reduced sensitivity to stimuli affecting the eye
- double vision
- proptosis, an eyeball that bulges outward
- enophthalmos, the opposite of proptosis, which refers to an eyeball that sinks inward
- vision loss, including blindness
If a person experiences trauma to the eye, the diagnostic process
While reduced visual acuity is a symptom of orbital emphysema, other eye conditions can also cause it, so a correct diagnosis will involve ruling out the other possibilities. Early diagnosis of the condition is critical to prevent vision loss.
According to older research from 2015, for those with typical eye movements and little or no double vision, doctors may recommend additional measures. Healthcare professionals sometimes prescribe antibiotics and nasal decongestants in cases of orbital fracture. Health experts also recommend avoiding blowing the nose for a couple of weeks.
If the emphysema progresses and is putting a person’s vision at risk, quickly removing the trapped air through direct needle drainage is necessary. This can prevent irreversible vision loss from stretching the optic nerve or compromising the blood supply. It is appropriate for individuals with increased eye pressure and:
- restricted eye movement
- decreased vision
- sluggish pupil reaction
Surgery to reconstruct the orbital wall may be necessary if a person
- double vision that is not resolving
- a large fracture
- a sinking eyeball of more than 2 millimeters
- limited eyeball movements
Orbital emphysema refers to the presence of air within the tissues of the orbit or eyelid. Trauma is the
Symptoms may involve restriction of eye movement, double vision, proptosis, or enophthalmos. In some cases, the effects can result in permanent vision loss.
Doctors use palpation, which involves using the hands to check the area, and a CT scan to diagnose orbital emphysema.
No treatment is usually necessary, but more serious cases may require air drainage with a needle or surgical reconstruction of the orbit.
If someone has symptoms of orbital emphysema, they should seek medical attention quickly because early treatment can prevent vision loss.