J Korean Ophthalmol Soc.  2013 Jan;54(1):180-183. 10.3341/jkos.2013.54.1.180.

Orbital Emphysema Causing Eye Movement Restriction Without Orbital Fractures Due to Compressed Air Injury

• Jung Y
• Moon HS
• Jung JW
• Chi MJ

• KMID: 2216470
• DOI: http://doi.org/10.3341/jkos.2013.54.1.180

Abstract

PURPOSE
The authors experienced a case of orbital emphysema causing eye movement disorder following conjunctival tear without any orbital wall fractures after exposure to compressed air.
CASE SUMMARY
A 28-year-old man's left periorbital area was injured while working with compressed air. There was marked lid swelling on the left side with palpable crepitus. The patient had an exotropia and hypertropia of the left eye. In addition, the extraocular movement of the left eye was restricted on upgaze without nausea and vomiting. On slit-lamp examination, conjunctival partial laceration and subconjunctival air bubbles adjacent to the conjunctival laceration could be seen. Orbital computed tomography showed air in the periorbital and retrobulbar region of the left eye and no evidence of orbital fracture. On examination 4 days after the primary repair of the conjunctival laceration, the patient completely recovered without any complication.
CONCLUSIONS
Orbital emphysema following a conjunctival laceration caused by compressed air without any orbital wall fractures can cause restriction of eye movement.

Keyword

Compressed air; Conjunctival laceration; Orbital emphysema

MeSH Terms

Adult
Compressed Air*
Emphysema*
Exotropia
Eye Movements*
Humans
Lacerations
Nausea
Ocular Motility Disorders
Orbit*
Orbital Fractures*
Strabismus
Vomiting

Figure

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  Figure 1. On slitlamp examination, subconjunctival air bubbles (A, black arrow) and conjunctival partial laceration (B, white arrows) could be seen.

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  Figure 2. He had an exotropia and hypertropia of the left eye (A). And the extraocular movement of left eye was restricted on upgaze (B).

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  Figure 3. Orbital CT scan shows air in the retrobulbar (A, white arrow), subconjunctival (B, black arrow), and subcutaneous (C, thick white arrow) area. Superior rectus muscle is downwardly positioned. There aren't any orbital wall fractures.

Reference

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