Orbital emphysema after sneezing.

Orbital emphysema is a rare condition in the absence of trauma or sinus disease. We report two cases of orbital emphysema caused by sneezing. The patients presented with sudden unilateral eyelid swelling after sneezing. Otorhinolaryngologic and ophthalmic examinations were accompanied by computed tomography (CT). Patient examination disclosed crepitant eyelid swelling, ptosis, and mild unilateral exophthalmos. CT demonstrated areas of emphysema in the orbit. One patient had history of past trauma. The other patient had a history of nasal surgery and concurrent chronic sinusitis. Sneezing may cause orbital emphysema in patients with a history of old periorbital trauma or surgery.