Most of the time orbital emphysema is a minor condition, but it can be a medical emergency if severe. An increase in pressure within the orbit can compress the globe, resulting in a compartment syndrome.
Parameters:
(1) amount of intra-orbital air
(2) signs and symptoms
(3) risk
Amount of Air
Signs/Symptoms
Risk
Stage
small (may only be seen on X-rays)
none
none
I
moderate, with globe displacement
proptosis, diplopia, lateral shift of globe
minimal
II
marked, with increased intra-ocular pressure
reduced vision
ischemic injury to optic nerve
III
marked, with high intra-ocular pressure
visual loss
permanent blindness from central retinal artery occlusion
IV
Intraorbital needle decompression can quickly reduce the pressure and preserve vision. Shameer et al described using a 23-gauge needle attached to a saline-filled syringe (? via butterfly) with the plunger removed.
To read more or access our algorithms and calculators, please log in or register.
