Orbital Emphysema due to Nose Blowing

Orbital emphysema is a rare ocular emergency in the absence of trauma, sinusitis and/or surgical intervention. We report a case of orbital emphysema in a 29-year-old male caused by forceful blowing of the nose. The patient presented with sudden and painful onset of right periorbital swelling and nose-bleed following forceful blowing of the nose. There was no history of sinusitis, facial trauma or previous surgery.Examination of the patient disclosed crepitant eyelid swelling, ptosis, and mild unilateral exophthalmos and inferomedial strabismus in the neutral position. Otorhinolaryngologic and ophthalmic examinations were accompanied by computerized tomography, which demonstrated areas of emphysema in the orbit. We present this article because orbital emphysema is a rare ocular emergency diagnosis in the absence of trauma. The purpose of this presentation is to stress the recognition of ocular emphysema and its simple and effective emergency treatment.