Orbital Emphysema and Diplopia following Thoracotomy

Abstract

Purpose To describe the clinical and radiological findings in a patient with diplopia and orbital emphysema following thoracotomy. Methods Reported is a 71-year-old woman who presented with diplopia several days following thoracotomy. Results Physical examination revealed diffuse subcutaneous emphysema and a right hypertropia. Head computed tomography revealed facial and palpebral subcutaneous emphysema extending into the infratemporal fossa and orbits bilaterally. A chest tube was replaced and her diplopia resolved. Conclusions Subcutaneous emphysema can lead to diplopia and orbital emphysema in the absence of orbital trauma. Contrary to previously suggested mechanisms of orbital emphysema associated with subcutaneous emphysema, computed tomography imaging suggested that air entry into the orbit in this case was through the inferior orbital fissure.