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Table of Contents    
LETTER TO EDITOR
Year : 2021  |  Volume : 69  |  Issue : 4  |  Page : 1084

Orbital Emphysema: A Diagnostic Dilemma


Neuro-ophthalmology Clinic and Glaucoma Service, AG Eye Hospital Puthur, Trichy, Tamil Nadu, India

Date of Submission06-Feb-2021
Date of Decision06-Feb-2021
Date of Acceptance23-Apr-2021
Date of Web Publication2-Sep-2021

Correspondence Address:
Nataraja Pillai Venugopal
AG Eye Hospital, Puthur, Trichy, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.325319

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How to cite this article:
Venugopal NP. Orbital Emphysema: A Diagnostic Dilemma. Neurol India 2021;69:1084

How to cite this URL:
Venugopal NP. Orbital Emphysema: A Diagnostic Dilemma. Neurol India [serial online] 2021 [cited 2021 Sep 18];69:1084. Available from: https://www.neurologyindia.com/text.asp?2021/69/4/1084/325319




Sir,

Post-operative visual loss (POVL) is a known complication following spinal surgery. We would like to highlight few points regarding orbital emphysema which may cause diagnostic dilemma if neuroimaging evaluations are delayed following POVL. The dehisence of lamina papyracea is a known anatomical variation of ethmoid bone.[1] Sen and Chaturvedi[2] reported a case of spontaneous orbital emphysema (SOE) following sneezing. The final diagnosis is dehisence of lamina papyracea with orbital emphysema. SOE may cause orbital compartment syndrome (OCS), central retinal artery occlusion (CRAO) and ischemic optic neuropathy (ION). Orbital air absorption may take up to one week.[3] Occasionally in POVL, neuroimaging evaluation may be delayed up to one week.[4] Probably in this situation, SOE should be considered as differential diagnosis. SOE would have caused OCS. Air would have been absorbed prior to neuroimaging study. To conclude, in POVL due to OCS following spine surgery, SOE should be considered if there is delay in neuroimaging study of more than a week. Financial constraints may be responsible for delay in neuroimaging study.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Akbari M, Alizade N. Dehiscence of lamina papyracea a normal variation: A case report in Iran. J Kermanshah Univ Med Sci 2019;23:e84196.  Back to cited text no. 1
    
2.
Sen D, Chaturvedi PK. Orbital emphysema following sneezing: A case report. Med J Armed Forces India 2011;67:282-4.  Back to cited text no. 2
    
3.
Linhart WO. Emphysema of orbit. J Am Med Assoc 1943;123:89-90.  Back to cited text no. 3
    
4.
Mukherjee B, Alam MS. Acute visual loss and ophthalmoplegia following spinal surgery: Report of a case and review of literature. Indian J Ophthalmol 2014;62:963-5.  Back to cited text no. 4
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