Introduction
Orbital emphysema refers to the infiltration of air or gas within the orbital soft tissue space. It is most commonly associated with a history of trauma or orbital wall fracture [1-3]. However, other mechanisms have been reported including infection, pulmonary barotrauma, and iatrogenic factors such as dental surgery [4]. Signs and symptoms include proptosis, crepitus, and diplopia presenting acutely or over the course of days to weeks [5, 6]. Although orbital emphysema typically follows a benign course and is self-limiting, in severe cases it can cause vision loss and require immediate intervention to prevent complications associated with orbital compartment syndrome [2, 7].
Herein, we present a case report of bilateral orbital emphysema in a single individual after chest tube placement for spontaneous pneumothorax. This case illustrates the potential for dramatic complications of such a procedure and the extensive pathways of communication along the fascial planes from the site of origin to the face and orbital region. This case report includes a review of the current literature.